Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, P. R. China.
Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, P. R. China.
World Neurosurg. 2019 May;125:e1074-e1081. doi: 10.1016/j.wneu.2019.02.004. Epub 2019 Feb 18.
To evaluate the safety and effectiveness of microsurgical clipping and endovascular embolization for the treatment of middle cerebral artery aneurysm (MCAA).
The clinical data of 482 patients with MCAA treated with microsurgical clipping or endovascular embolization were analyzed retrospectively. According to whether the aneurysms were ruptured, patients were divided into a ruptured group and an unruptured group. Demographics, clinical manifestation, and postoperative complications were recorded.
In the microsurgical clipping group (257 patients), there were 114 male and 143 female patients. The mean age was (55 ± 10) years and the mean course of disease was 3 (1, 36) days. The total numbers of MCAA were 274, including 179 ruptured aneurysms and 95 unruptured aneurysms. In the endovascular embolization group (225 patients), there were 98 male and 127 female patients. The mean age was (54 ± 11) years and the mean course of disease was 10 (1, 55) days. The total numbers of MCAA were 234, including 126 ruptured aneurysms and 108 unruptured aneurysms. There was no difference between the incidence of complications in the ruptured and unruptured groups. The outcome of the endovascular embolization group was better than the microsurgical clipping group in ruptured aneurysms (P = 0.000). The recurrence rate of the endovascular embolization group was greater than the microsurgical clipping group in ruptured aneurysms (P = 0.023).
Both microsurgical clipping and endovascular embolization were safe and effective methods for the treatment of MCAA, but patients with ruptured MCAAs treated with endovascular embolization were more likely to experience recurrence.
评估显微夹闭术和血管内栓塞术治疗大脑中动脉动脉瘤（MCAAs）的安全性和有效性。
回顾性分析 482 例接受显微夹闭术或血管内栓塞术治疗的 MCAAs 患者的临床资料。根据动脉瘤是否破裂，将患者分为破裂组和未破裂组。记录患者的人口统计学、临床表现和术后并发症。
在显微夹闭组（257 例）中，男性 114 例，女性 143 例。平均年龄（55±10）岁，平均病程 3（1，36）天。MCAAs 总数为 274 个，其中 179 个为破裂动脉瘤，95 个为未破裂动脉瘤。在血管内栓塞组（225 例）中，男性 98 例，女性 127 例。平均年龄（54±11）岁，平均病程 10（1，55）天。MCAAs 总数为 234 个，其中 126 个为破裂动脉瘤，108 个为未破裂动脉瘤。破裂组和未破裂组并发症发生率无差异。在破裂动脉瘤中，血管内栓塞组的治疗效果优于显微夹闭组（P=0.000）。破裂动脉瘤中，血管内栓塞组的复发率高于显微夹闭组（P=0.023）。
显微夹闭术和血管内栓塞术都是治疗 MCAAs 的安全有效的方法，但血管内栓塞术治疗破裂 MCAAs 的患者更有可能出现复发。
