Analysis on clinical effect of endovascular embolization and surgical clipping in the treatment of intracranial aneurysms of anterior circulation

Abstract

Objective To investigate the influence of endovascular embolization and surgical clipping on long-term prognosis, quality of life and postoperative complications of patients with anterior circulation intracranial aneurysms. Methods A total of 128 patients with anterior circulation intracranial aneurysms were chosen from January 2016 to October 2017 and randomly divided into 2 groups including group A (N = 64) treated with endovascular embolization and group B (N = 64) treated with surgical clipping. The hospitalization time, total treatment cost, laboratory indexes before and after operation including S-100B protein (S-100B), matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6), postoperative neurological function [Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS)], life quality [Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and Activities of Daily Living (ADL)] and postoperative complications incidence of both groups were compared and analyzed. Results Compared with group B, group A had shorter hospitalization time (t = 4.712, P = 0.000), significantly lower levels of S-100B (F = 4.276, P = 0.000), MMP-9 (F = 3.576, P = 0.000) and IL-6 (F = 3.897, P = 0.000), better SF-36 (t = 4.673, P = 0.000) and ADL (t = 3.816, P = 0.000) scores, better GOS (χ² = 4.726, P = 0.019) and mRS (t = 3.816, P = 0.000) scores 6 months after operation. However, the total treatment cost of group A was significantly higher than group B (t = 5.046, P = 0.000). The evaluation of postoperative complications incidence 30 d after operation showed group A had significantly lower infection incidence (χ² = 9.195, P = 0.002) than group B, while there was no significant difference in the incidence of aneurysm rupture, cerebral ischemia, and vasospasm incidence between 2 groups (P > 0.05, for all). Conclusions Endovascular embolization in the treatment of anterior circulation intracranial aneurysms can efficiently shorten hospitalization time, improve long-term prognosis, reduce the levels of S-100B, MMP-9 and IL-6, improve patients' quality of life and be helpful to prevent the infection risk. Surgical clipping has the advantage of reducing the economic burden of patients.

DOI: 10.3969/j.issn.1672-6731.2019.05.011