Major intraoperative aneurysm rupture may increase the risk of cerebral infarction following surgical clipping of unruptured intracranial aneurysms
Major intraoperative aneurysm rupture may increase the risk of cerebral infarction following surgical clipping of unruptured intracranial aneurysms
复制标题
手术夹闭未破裂的颅内动脉瘤后，术中主要动脉瘤破裂可能会增加脑梗塞的风险
DOI：
10.1016/j.jocn.2020.10.029
复制
发表时间：
2020-12
影响因子：
2
通讯作者：
Wang Shuo
中科院分区：
文献类型：
--
作者：
Liu Qingyuan;Wu Jun;Li Maogui;Jiang Pengjun;Yang Junhua;Yang Shuzhe;Guo Rui;Cao Yong;Zhao Yuanli;Wang Shuo
术中动脉瘤破裂（IAR）可能导致不良结局。本研究旨在探讨IAR与术后脑梗死（CI）之间的关系。方法我们回顾性分析了2016年1月至2019年6月在两个神经外科中心接受显微手术夹闭的无症状未破裂颅内动脉瘤（UIA）患者。进行倾向评分匹配以构成队列。收集有关临床和放射学特征的数据。记录夹闭后1-2周的CI和2周的功能结局。比较有CI和无CI的IAR患者之间的差异。IARs和术后CI之间的关系进行了调查，通过使用Logistic回归analysis.ResultsThis研究产生了96 UIAs患者，包括48例患者进行IARs和48例患者没有。确定了20例在夹闭后1-2周具有CI的患者。接受IAR的患者的CI率高于未接受IAR的患者（OR，2.88; p = 0.038）;此外，接受IAR的患者的mRS也更差（OR，1.58; p = 0.015）。对于接受IAR的患者，缺血性脑血管疾病（OR，6.40; p = 0.048）、埃森卒中风险评分（OR，2.14; p = 0.026）和术中破裂严重程度（OR，5.63; p = 0.023）具有显著性。多因素Logistic回归分析显示，严重IAR（OR 6.09; CI 1.18-31.53; p = 0.031）是术后CI的独立危险因素。
ObjectiveIntraoperative aneurysm rupture (IAR) could cause a poor outcome. This study aimed to investigate the relationship between IARs and postoperative cerebral infarctions (CIs).MethodWe retrospectively reviewed patients with asymptomatic unruptured intracranial aneurysms (UIAs) who received microsurgical clipping in two neurosurgical centers from January 2016 to June 2019. A propensity score matching was done to constitute a cohort. The data were collected regarding the clinical and radiological characteristics. The CI at 1–2 weeks and the functional outcome at two weeks after clipping were recorded. Differences between IAR patients with CIs and without CIs were compared. The relationship between the IARs and postoperative CIs was investigated by using logistic regression analysis.ResultsThis study yielded 96 UIAs patients, including 48 patients undergoing IARs and 48 patients not. Twenty patients with CIs at 1–2 weeks after clipping were identified. The rate of CIs in patients undergoing IARs was higher than that in patients not undergoing IARs (OR, 2.88; p = 0.038); moreover, the mRS was also worse in patients undergoing IARs (OR, 1.58; p = 0.015). For patients undergoing IARs, the significance was found in ischemic cerebrovascular disease (OR, 6.40; p = 0.048), Essen stroke risk score (OR, 2.14; p = 0.026), and severity of intraoperative rupture (OR, 5.63; p = 0.023). The multivariate logistic analysis demonstrated the major IARs (OR, 6.09; CI, 1.18–31.53; p = 0.031) as the independent risk factor related to postoperative CI.ConclusionIARs could increase the risk of postoperative CIs and worsen the functional outcome, and major IAR was the independent risk factor related to the postoperative CIs.
登录
查看更多内容
影响因子：
--
作者：
E. V. van Lindert;H. Böcher-Schwarz;A. Perneczky
通讯作者：
E. V. van Lindert;H. Böcher-Schwarz;A. Perneczky
影响因子：
9.9
作者：
Tatu, L;Moulin, T;Duvernoy, H
通讯作者：
Duvernoy, H
影响因子：
11.3
作者：
Chieffo, Alaide;Petronio, Anna Sonia;Mehran, Roxana
通讯作者：
Mehran, Roxana
DOI：
10.1159/000333602
发表时间：
2012-01-01
期刊：
MANIFESTATIONS OF STROKE
影响因子：
--
作者：
Tatu, Laurent;Moulin, Thierry;Bogousslavsky, Julien
通讯作者：
Bogousslavsky, Julien
影响因子：
2.6
作者：
Colby, Geoffrey P.;Coon, Alexander L.;Tamargo, Rafael J.
通讯作者：
Tamargo, Rafael J.