Clinical Effect of Craniotomy Clipping and Vascular Embolization in the Treatment of Cerebral Aneurysms
The treatment of IV-V cerebral aneurysms defined by the World Federation of Neurosurgery Societies (WFNS) remains unclear and controversial. In this study, we compared the clinical efficacy and safety of craniotomy and interventional embolization in the treatment of ruptured cerebral aneurysms. We collected 100 patients with cerebral aneurysms in our hospital. Preoperative baseline, postoperative complications and outcomes were analyzed. Multivariate logistic regression analysis was used to determine risk factors for short-term mortality. A total of 19 patients died during short-term follow-up; the short-term mortality rate in the coiled group was higher (37%, 16%, P = 0.015). The incidence of delayed cerebral ischemia and intracranial infection in craniotomy clipping group was significantly higher than that in vascular interventional embolization group (32%, 13%, P = 0.045) and (67%, 40%, P = 0.016). However, the incidence of hydrocephalus was higher in the interventional embolization group (22%, 7%, P = 0.035). Multivariate logistic regression analysis showed that cerebral vasospasm (odds ratio: 9.22, P < 0.01), admission WFNS grade V (OR, 15.43; P < 0.01), vascular interventional embolization (OR, 5.92; P = 0.013) and aneurysm rebleeding (OR, 40.04; P = 0.01) could affect mortality. The short-term mortality rate of patients with ruptured cerebral aneurysms after craniotomy and clipping is low. Cerebral vasospasm, WFNS V grade and aneurysm rebleeding after surgery were associated with short-term mortality.