Analysis of related factors of aneurysm re-recurrence after secondary embolization
Fang Zhijun1, Zhang Dong2
1Department of Neurosurgery, People's Hospital of Beijing Daxing District, Beijing 102600, China; 2Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University Beijing 100070, China
Abstract:Objective To explore the influencing factors of recurrence after interventional treatment of recurrent aneurysms after intracranial embolization.Methods The retrospective cross-sectional study was conducted. A total of 69 recurrent aneurysms patients received secondary intervention from January 2010 to December 2016 were retrospectively analyzed, including 27 males and 42 females with age of 25-76(48±10) years. Thirteen patients relapsed after second intervention, and the recurrence rate was 18.8%(13/69). Univariate analysis and further logistic regression analysis were used to analyze the influencing factors of recurrence of recurrent intracranial aneurysms after interventional therapy.Results Univariate analysis showed that there was no significant difference in gender, age, hypertension, diabetes mellitus, smoking, aneurysm neck width, aneurysm site, or stent-assisted combination between the recurrent and non-recurrent groups (all P values >0.05).The aneurysm size, the change of the modified RANKIN scale (mRS) score before and after surgery, and the postoperative Raymond grade were statistically significant (Z=-3.396, -5.955, -5.825, all P values<0.05). Logistic regression analysis showed that Raymond Ⅱ(OR=0.116, 95% CI 0.025-0.546, P<0.01) and Raymond Ⅲ(OR=0.052, 95% CI 0.008-0.350, P<0.01) were independent risk factors for recurrence of aneurysms after secondary interventional embolization according with Raymond I as the reference.Conclusions Incomplete embolization (Raymond Ⅱ grade and Ⅲ grade) is an independent risk factor for intracranial aneurysms re-recurrence after interventional embolization. For recurrent intracranial aneurysms, appropriate coil and embolic materials should be selected.Complete embolization without residual during the interventional procedure means lower rate of recurrence.
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