Prognostic Analysis of Endovascular Embolization and Surgical Clipping for Posterior Communicating Artery Aneurysm Caused Oculomotor Palsy in Elder Patients

ZHANG Chang-wei; WANG Chao-hua; XU Ding

doi:10.3969/j.issn.1002-3429.2017.04.024

Abstract：Objective To study the prognostic analysis of endovascular embolization and surgical clipping for posterior communicating artery aneurysm caused oculomotor palsy in elder patients.Methods 322 cases of elderly patients in our hospital from the January 2008-2013 year in June were analyzed retrospectively, whose symptoms were oculomotor paralysis caused by Posterior communicating artery aneurysm.According to the different ways of operation, these patients were divided into embolization group and occlusion group.The embolization group were 162 cases, 160 cases were clipped.Related surgical factors, recover of OP and postoperative complications were compared.Results The embolization group operation time(2.11±0.28)h, recovery time of spontaneous breath in time(0.58±0.12)h were significantly shorter than the clipping group, and the amount of bleeding(9.35±3.61)ml was less than the clipping group, the differences between the two groups were statistically significant (P<0.01).The recovery effect of clipping group was better than that of embolization group, the difference was statistically significant (P<0.05), but there was no significant differences in recovery rate between the two groups (P>0.05).The postoperative complications such as cerebral infarction, vasospasm, cerebral edema, dehydration and other complications were significantly less than that of the clipping group, and the difference was statistically significant (P<0.05 or P<0.01).Conclusion Endovascular embolization and microsurgical clipping have their advantages and disadvantages for aneurysm oculomotor paralysis in elderly patients, and clinicians should be based on the comprehensive conditions of patients suggest appropriate surgical modality for patients.