Complications Following Endovascular Embolization for Small and Medium-Sized Intracranial Aneurysms and Analysis of High-Risk Factors for Recurrence

SUN Wenqiang; ZHANG Jie; WANG Hongliang

doi:10.3639/i.issn.2095-3097.2024.10.030

Abstract：Objective To investigate the complications following endovascular embolization for small and medium-sized intracranial aneurysms and high-risk factors for recurrence.Methods The clinical data of 87 patients with small and medium-sized intracranial aneurysms who underwent endovascular embolization in the Neurology Department of Nantong Sixth People's Hospital from January 2020 to December 2022 were retrospectively analyzed.All patients were followed up for 6 months,and the incidence of postoperative complications was calculated.According to whether there was recurrence after surgery,the patients were divided into non-recurrence group(n=74)and recurrence group(n=13).The clinical data of the two groups were compared,and a multivariate Logistic regression model was used to analyze the high-risk factors affecting the recurrence after endovascular embolization for small and medium-sized aneurysms.Results Among the 87 patients,12 had complications,and the complication incidence rate was 13.79％.There were 2 cases of epilepsy,3 cases of hydrocephalus,2 cases of cerebral infarction,3 cases of cerebral vasospasm,and 2 cases of intracranial infection.Univariate analysis results showed that there were statistically significant differences in age,combined diabetes,combined hypertension,Hunt-Hess grade,stent assistance,and surgical timing between the recurrence group and the non-recurrence group(P＜0.05).Multivariate analysis showed that age≥60 years old(OR=1.729,95％CI:1.245-2.447),combined diabetes(OR=2.147,95％CI:1.678-3.253),combined hypertension(OR=2.352,95％CI:1.740-3.411),Hunt-Hess grade≥Ⅲ level(OR=1.953,95％CI:1.360-2.721),without stent assistance(OR=1.785,95％CI:1.279-2.510),and surgical timing≥24 h(OR=1.521,95％CI:1.190-1.938)were high-risk factors for recurrence after endovascular embolization for small and medium-sized aneurysms(P＜0.05).Conclusion Endovascular embolization for small and medium-sized intracranial aneurysms has a low complication incidence rate but a relatively high recurrence rate.Age,complications,Hunt-Hess grade,stent assistance,and surgical timing are the influencing factors for recurrence.