Analysis of prognosis and risk factors of 730 patients with anterior communicating aneurysm

Abstract

Objective: To investigate the prognosis and risk factors of patients with anterior communicating aneurysm treated by aneurysm clipping or interventional embolization. Methods: The clinical data of 730 patients with anterior communicating aneurysm who underwent aneurysm clipping or interventional embolization in the department of neurosurgery, the first affiliated hospital of Soochow University from January 1999 to December 2018 were retrospectively analyzed. The prognosis of patients in the clipping group from 1999 to 2008 and the clipping group from 2009 to 2018, the clipping group from 2009 to 2018 and the interventional group from 2009 to 2018 were compared respectively, and the risk factors affecting the prognosis of patients were statistically analyzed. Results: The rate of poor prognosis was 32.7% in the clipping group from 1999 to 2008, 21.3% in the clipping group from 2009 to 2018, and the rate of intraoperative aneurysm rupture and postoperative cerebral infarction was lower in the clipping group from 2009 to 2018 (P<0.05). There was no significant statistical difference in the prognosis between the clipping group and the interventional group from 2009 to 2018 (P>0.05). The results of multivariate analysis showed that preoperative Hunt-Hess grade, postoperative cerebral infarction and postoperative hemorrhage were the risk factors affecting the prognosis of patients (P<0.05). Conclusion: The prognosis of patients treated by clipping from 2009 to 2018 was significantly improved compared with that from 1999 to 2008. There was no significant difference in the prognosis between the clipping group and the interventional group from 2009 to 2018. Preoperative Hunt-Hess grading, postoperative cerebral infarction and postoperative hemorrhage were independent risk factors affecting the prognosis.