Risk factors for cerebral thrombosis due to interventional embolization of intracranial aneurysms_West China Medical Journal

Authors：

LI Fei ,  CHEN Qianxue , WANG Junmin , LIU Zaiming , YE Hui , ZHOU Long

Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P. R. China;

Corresponding?author：

CHEN Qianxue, Email: chenqx666@sohu.com

Keywords：

Intracranial aneurysms; Interventional embolization; Cerebral thrombosis; Risk factors; Operative duration

DOI：

10.7507/1002-0179.202004102

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Objective To explore the risk factors for cerebral thrombosis due to interventional embolization of intracranial aneurysms.Methods The clinical data of 240 patients with intracranial aneurysms treated by interventional embolization in Department of Neurosurgery, Renmin Hospital of Wuhan University between January 2015 and December 2019 were collected retrospectively. According to whether cerebral thrombosis occurred after embolization, the patients were divided into the cerebral thrombosis group and the non-cerebral thrombosis group. Univariate analyses and multivariate logistic regression analysis were used to analyze the independent risk factors for cerebral thrombosis due to interventional embolization of intracranial aneurysms.Results Of the 240 patients, 55 (22.9%) had postoperative cerebral thrombosis confirmed by MRI, and 15 (6.2%) had neurological symptoms. There were significant differences in age, hypertension, hyperlipidemia, operative duration, and procedure methods (simple coiling, balloon or stent-assisted coiling) between the cerebral thrombosis group and the non-cerebral thrombosis group after embolization of intracranial aneurysms (P<0.05). Multivariate logistic regression analysis showed that only operative duration [odds ratio=1.036, 95% confidence interval (1.018, 1.054), P<0.001] was the independent risk factor for cerebral thrombosis after interventional embolization of aneurysms.Conclusions Operative duration is the independent and adjustable risk factor for cerebral thrombosis after embolization of intracranial aneurysms. Improving the surgical skills of neurointerventional surgeons and shortening the procedure time will be helpful to reduce the occurrence of cerebral thrombosis after interventional treatment of aneurysms and improve the prognosis of patients.

Citation： LI Fei, CHEN Qianxue, WANG Junmin, LIU Zaiming, YE Hui, ZHOU Long. Risk factors for cerebral thrombosis due to interventional embolization of intracranial aneurysms. West China Medical Journal, 2021, 36(7): 889-893. doi: 10.7507/1002-0179.202004102 Copy

1.	Zuo Q, Yang P, Lv N, et al. Safety of coiling with stent placement for the treatment of ruptured wide-necked intracranial aneurysms: a contemporary cohort study in a high-volume center after improvement of skills and strategy. J Neurosurg, 2018, 131(2): 435-441.
2.	唐海雙, 賀曉武, 左喬, 等. 支架輔助彈簧圈栓塞治療急性期顱內破裂動脈瘤的圍手術期危險因素分析. 第二軍醫大學學報, 2019, 40(2): 117-124.
3.	李航, 白衛星, 賀迎坤, 等. Pipeline^TM栓塞裝置治療顱內動脈瘤術后并發癥研究進展. 介入放射學雜志, 2017, 26(8): 760-764.
4.	Su W, Zhang Y, Chen J, et al. 225 intracranial aneurysms treated with the low-profile visualized intraluminal support (LVIS) stent: a single-center retrospective study. Neurol Res, 2018, 40(6): 445-451.
5.	Wallace AN, Grossberg JA, Almandoz J, et al. Endovascular treatment of posterior cerebral artery aneurysms with flow diversion: case series and systematic review. Neurosurgery, 2018, 83(4): 790-799.
6.	Tokunaga K, Hatano T, Nakahara I, et al. Factors associated with postprocedural diffusion-weighted imaging-positive lesions in endovascular treatment for unruptured cerebral aneurysms. World Neurosurg, 2019, 130: e457-e462.
7.	楊忠慶, 樸金偉, 張衛東. 顱內動脈瘤介入術后腦缺血并發癥的相關因素分析. 國際神經病學神經外科學雜志, 2020, 47(1): 14-17.
8.	Kang HS, Han MH, Kwon BJ, et al. Is clopidogrel premedication useful to reduce thromboembolic events during coil embolization for unruptured intracranial aneurysms?. Neurosurgery, 2010, 67(5): 1371-1376.
9.	Kocur D, Pa?dziora P, Przyby?ko N, et al. Thromboembolism during coiling of intracranial aneurysms: predictors and clinical outcome. Wideochir Inne Tech Maloinwazyjne, 2020, 15(2): 319-328.
10.	Nagahata M, Kondo R, Saito S, et al. Which factors increase procedural thromboembolic events in patients with unruptured paraclinoid internal carotid artery aneurysm treated by coil embolization?. Neuroradiol J, 2011, 24(5): 712-714.
11.	中華醫學會神經病學分會腦血管病學組缺血性腦血管病血管內介入診療指南撰寫組. 中國缺血性腦血管病血管內介入診療指南. 中華神經科雜志, 2011, 44(12): 863-869.
12.	Song J, Kim BS, Shin YS. Treatment outcomes of unruptured intracranial aneurysm; experience of 1, 231 consecutive aneurysms. Acta Neurochir (Wien), 2015, 157(8): 1303-1310.
13.	Ji W, Liu A, Lv X, et al. Risk score for neurological complications after endovascular treatment of unruptured intracranial aneurysms. Stroke, 2016, 47(4): 971-978.
14.	Shimizu K, Imamura H, Mineharu Y, et al. Endovascular treatment of unruptured paraclinoid aneurysms: single-center experience with 400 cases and literature review. AJNR Am J Neuroradiol, 2016, 37(4): 679-685.
15.	李力, 呂楠, 趙瑞, 等. 顱內未破裂動脈瘤血管內介入治療程序相關性缺血性并發癥的危險因素及臨床特點分析. 第二軍醫大學學報, 2018, 39(1): 50-56.
16.	顧大群, 張揚, 晁迎九, 等. 顱內破裂動脈瘤栓塞治療并發血栓事件的危險因素分析. 中國神經精神疾病雜志, 2014, 40(11): 697-701.
17.	Hahnemann ML, Ringelstein A, Sandalcioglu IE, et al. Silent embolism after stent-assisted coiling of cerebral aneurysms: diffusion-weighted MRI study of 75 cases. J Neurointerv Surg, 2014, 6(6): 461-465.
18.	Lee SH, Jang MU, Kang J, et al. Impact of reducing the procedure time on thromboembolism after coil embolization of cerebral aneurysms. Front Neurol, 2018, 9: 1125.
19.	夏鵬飛, 王偉, 高旭婷, 等. 顱內未破裂動脈瘤介入術后腦缺血性損傷的危險因素分析. 重慶醫科大學學報, 2018, 43(2): 202-205.
20.	Jo KI, Yeon JY, Kim KH, et al. Predictors of thromboembolism during coil embolization in patients with unruptured intracranial aneurysm. Acta Neurochir (Wien), 2013, 155(6): 1101-1106.

1. Zuo Q, Yang P, Lv N, et al. Safety of coiling with stent placement for the treatment of ruptured wide-necked intracranial aneurysms: a contemporary cohort study in a high-volume center after improvement of skills and strategy. J Neurosurg, 2018, 131(2): 435-441.
2. 唐海雙, 賀曉武, 左喬, 等. 支架輔助彈簧圈栓塞治療急性期顱內破裂動脈瘤的圍手術期危險因素分析. 第二軍醫大學學報, 2019, 40(2): 117-124.
3. 李航, 白衛星, 賀迎坤, 等. Pipeline^TM栓塞裝置治療顱內動脈瘤術后并發癥研究進展. 介入放射學雜志, 2017, 26(8): 760-764.
4. Su W, Zhang Y, Chen J, et al. 225 intracranial aneurysms treated with the low-profile visualized intraluminal support (LVIS) stent: a single-center retrospective study. Neurol Res, 2018, 40(6): 445-451.
5. Wallace AN, Grossberg JA, Almandoz J, et al. Endovascular treatment of posterior cerebral artery aneurysms with flow diversion: case series and systematic review. Neurosurgery, 2018, 83(4): 790-799.
6. Tokunaga K, Hatano T, Nakahara I, et al. Factors associated with postprocedural diffusion-weighted imaging-positive lesions in endovascular treatment for unruptured cerebral aneurysms. World Neurosurg, 2019, 130: e457-e462.
7. 楊忠慶, 樸金偉, 張衛東. 顱內動脈瘤介入術后腦缺血并發癥的相關因素分析. 國際神經病學神經外科學雜志, 2020, 47(1): 14-17.
8. Kang HS, Han MH, Kwon BJ, et al. Is clopidogrel premedication useful to reduce thromboembolic events during coil embolization for unruptured intracranial aneurysms?. Neurosurgery, 2010, 67(5): 1371-1376.
9. Kocur D, Pa?dziora P, Przyby?ko N, et al. Thromboembolism during coiling of intracranial aneurysms: predictors and clinical outcome. Wideochir Inne Tech Maloinwazyjne, 2020, 15(2): 319-328.
10. Nagahata M, Kondo R, Saito S, et al. Which factors increase procedural thromboembolic events in patients with unruptured paraclinoid internal carotid artery aneurysm treated by coil embolization?. Neuroradiol J, 2011, 24(5): 712-714.
11. 中華醫學會神經病學分會腦血管病學組缺血性腦血管病血管內介入診療指南撰寫組. 中國缺血性腦血管病血管內介入診療指南. 中華神經科雜志, 2011, 44(12): 863-869.
12. Song J, Kim BS, Shin YS. Treatment outcomes of unruptured intracranial aneurysm; experience of 1, 231 consecutive aneurysms. Acta Neurochir (Wien), 2015, 157(8): 1303-1310.
13. Ji W, Liu A, Lv X, et al. Risk score for neurological complications after endovascular treatment of unruptured intracranial aneurysms. Stroke, 2016, 47(4): 971-978.
14. Shimizu K, Imamura H, Mineharu Y, et al. Endovascular treatment of unruptured paraclinoid aneurysms: single-center experience with 400 cases and literature review. AJNR Am J Neuroradiol, 2016, 37(4): 679-685.
15. 李力, 呂楠, 趙瑞, 等. 顱內未破裂動脈瘤血管內介入治療程序相關性缺血性并發癥的危險因素及臨床特點分析. 第二軍醫大學學報, 2018, 39(1): 50-56.
16. 顧大群, 張揚, 晁迎九, 等. 顱內破裂動脈瘤栓塞治療并發血栓事件的危險因素分析. 中國神經精神疾病雜志, 2014, 40(11): 697-701.
17. Hahnemann ML, Ringelstein A, Sandalcioglu IE, et al. Silent embolism after stent-assisted coiling of cerebral aneurysms: diffusion-weighted MRI study of 75 cases. J Neurointerv Surg, 2014, 6(6): 461-465.
18. Lee SH, Jang MU, Kang J, et al. Impact of reducing the procedure time on thromboembolism after coil embolization of cerebral aneurysms. Front Neurol, 2018, 9: 1125.
19. 夏鵬飛, 王偉, 高旭婷, 等. 顱內未破裂動脈瘤介入術后腦缺血性損傷的危險因素分析. 重慶醫科大學學報, 2018, 43(2): 202-205.
20. Jo KI, Yeon JY, Kim KH, et al. Predictors of thromboembolism during coil embolization in patients with unruptured intracranial aneurysm. Acta Neurochir (Wien), 2013, 155(6): 1101-1106.

West China Medical Journal

Risk factors for cerebral thrombosis due to interventional embolization of intracranial aneurysms

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