Analysis of the clinical effect of transcranial clipping and endovascular embolization on elderly patients with cerebral aneurysm

HUANG Shuangying; LIU Xu; JIN Man

doi:10.3969/j.issn.1002-7386.2025.01.014

Abstract：Objective To explore the clinical effect of transcranial clipping and endovascular embolization on the elderly patients with cerebral aneurysm,and to analyze the influence on serum peroxisome proliferator-activated receptor gamma(PPAR-γ)and endothelin-1(ET-1).Methods From March 2021 to March 2023,86 patients with cerebral aneurysm(ruptured)who were operated in our hospital were divided into two groups according to the random number table,with 43 cases in the observation group and 43 cases in the control group.Patients in the control group were treated by transcranial vascular occlusion,and those in the observation group were treated by endovascular embolization.The general data,including age,gender,body mass index(BMI),systolic blood pressure,underlying diseases,medication history,preoperative and postoperative Hunt and Hess grade,education level,serum PPAR-γ and ET-1 levels preoperatively and at 2 weeks and 4 weeks postoperatively,postoperative complications and survival were compared.Results There were no significant differences in age,gender,BMI,systolic blood pressure,basic disease,medication history,preoperative Hunt and Hess grade and education level between the two groups(P＞0.05).A significant difference was detected in the Hunt and Hess grade one month after operation(P＜0.05),which was significantly superior in the observation group than the control group(P＜0.05).Repeated analysis of variance showed a significant difference in serum PPAR-y before and after operation in both groups(P＜0.05),which was significantly elevated after operation in both groups(P＜0.05).Serum PPAR-γ at 2 weeks and 4 weeks postoperatively was significantly higher in the observation group than the control group(P＜0.05).Repeated analysis of variance showed a significant difference in serum ET-1 before and after operation in both groups(P＜0.05),which was significantly reduced after operation in both groups(P＜0.05).Serum ET-1 at 2 weeks and 4 weeks postoperatively was significantly lower in the observation group than the control group(P＜0.05).The incidence of postoperative complications was significantly lower in the observation group than the control group(P＜0.05).The survival curve showed a significantly longer survival time in the observation group than that of the control group(P＜0.05).Conclusion Interventional embolization is superior to transcranial clipping in effectively improving the curative effect of cerebral aneurysm patients,enhancing serum PPAR-γ and ET-1,and reducing the incidence of complications.It is worthy of clinical promotion.