The Effect of Endovascular Interventional Embolization Versus Microscopic Craniotomy on Surgical Success in Pa-tients with Hunt-Hess Grade Ⅲ Intracranial Ruptured Aneurysms

Gao Mingming; Yan Huiying; Liu Baohua

doi:10.3969/j.issn.1004-5775.2023.23.004

Abstract：Objective:To investigate the effect of performing endovascular interventional embolization and microscopic cranioto-my on the surgical success rate of patients with Hunt-Hess grade Ⅲ intracranial ruptured aneurysms.Methods:94 patients with Hunt-Hess grade Ⅲ intracranial ruptured aneurysms admitted to the hospital from January 2018 to December 2021 were selected as the study subjects,and were divided into two groups according to different surgical treatment plans,with 47 patients in each group.Endovascular interventional embolization was performed in the study group,and microscopic craniotomy was performed in the control group.The surgical indexes,serum cortisol(Cor),D-Dimer(D-D),interleukin 6(IL-6),adrenaline(A)indexes expres-sion levels,complication occurrences and surgical success rates were compared between the two groups.Results:Compared with patients in the control group,patients in the study group had shorter operative time and hospitalization and less intraoperative bleeding,with statistically significant differences(t=3.273,12.416,40.320,P＜0.05).After surgery,the expression levels of Cor,D-D,IL-6,and A indexes in the serum of patients in both groups were lower than those before surgery,and the expression levels of all indexes in the study group were lower than those in the control group,and the difference was statistically significant(t= 4.265,3.078,2.174,7.608,P＜0.05).The postoperative complication rate of patients in the study group was lower than that of the control group,and the difference was statistically significant(χ2=4.681,P＜0.05).The difference in surgical success rate between the two groups was not statistically significant(χ2=0.178,P＞0.05).Conclusion:Endovascular interventional embolization of Hunt-Hess grade Ⅲ intracranial ruptured aneurysm patients can effectively reduce the damage of surgery to the patients'body,reduce the incidence of complications,promote rapid recovery,and improve the success rate of surgery.Microscopic craniotomy is less expensive and has a wider scope of application and a higher success rate.