Risk factors for periprocedural ischemic stroke following endovascular treatment of intracranial aneurysms

• 作者: Zhang Yisen Wang Chao Tian Zhongbin Zhu Wei Li Wenqiang Yang Xinjian Liu Jian Zhang Ying
• 来源期刊: 中华神经外科杂志（英文）
• 关键词: Periprocedural ischemic stroke Endovascular treatment Intracranial aneurysms Aneurysm size Treatment modality
• 年，卷（期）: 2022,（1）
• 所属期刊栏目: Research
• 页码范围: 45-50
• 页数: 6页
• 语种: 中文
• DOI: 10.1186/s41016-021-00255-z

摘要

Background::The aim of this study was to comprehensively evaluate the risk factors of periprocedural ischemic stroke associated with endovascular treatment of intracranial aneurysms using a real-world database.Methods::From August 2016 to March 2017, 167 patients were enrolled. Univariate analysis and multivariate logistic regression analysis were used to examine the risk factors for periprocedural ischemic stroke.Results::Among the 167 cases, periprocedural ischemic stroke occurred in 20 cases (11.98%). After univariate analysis, the ischemic group had a higher proportion of large (≥ 10 mm) aneurysms than the control group (45.0% vs. 23.1%, p= 0.036). The incidence of periprocedural ischemic stroke was higher in cases treated by flow diverter (21.6%) or stent-assisted coiling (11.8%) than in cases treated by coiling only (2.7%), and the differences were statistically significant ( p = 0.043). After multivariate logistic regression analysis, treatment modality was the independent risk factor for periprocedural ischemic stroke. Compared with the coiling-only procedure, flow diverter therapy was associated with a significantly higher rate of periprocedural ischemic stroke (OR 9.931; 95% CI 1.174-84.038; p = 0.035). Conclusions::Aneurysm size and treatment modality were associated with periprocedural ischemic stroke. Larger aneurysms were associated with increased risk of periprocedural ischemic stroke. Flow diverter therapy was associated with significantly more periprocedural ischemic stroke than the coiling procedure alone.