Clinical analysis on 16 cases of cerebral rebleeding after stent-assisted embolization of ruptured intracranial aneurysm

Abstract

Objective To analyze the causes and prevention of cerebral rebleeding after stent-assisted embolization of ruptured intracranial aneurysm Methods A total of 655 patients who underwent single-stent-assisted spring coil embolization of an intracranial ruptured aneurysm from January 2011 to December 2017 in the First Affiliated Hospital of Zhengzhou University were selected. Of them, 16 patients with single aneurysms had perioperative surgery-related re-hemorrhage, 4 males and 12 females, aged 21 to 84 years. The re-hemorrhage and clinical outcomes of 16 patients were counted, and the modified Rankin (mRS) score was evaluated. Results The incidence of perioperative rebleeding in 655 patients was 2.4% (16/655). In the 16 cases, 9 cases had intraoper-ative aneurysm rebleeding, 5 cases died, 1 case had mRS score 4 points, and 3 cases mRS score 1 point. There were 7 cases of postoperative rebleeding, 5 cases of aneurysm rebleeding, 4 cases of death, 1 case of decompressive craniectomy after interventional therapy, and mRS score was 4 points at discharge. Two cases of brain parenchymal hemorrhage, 1 case of death, 1 case of cerebral infarction after discontinuation of dual antiplatelet aggregation drugs, mRS score was 2 points at discharge. Conclusions The causes of rebleeding after interventional treatment of ruptured aneurysm are complicated. For surgical rebleeding, the anti-platelet aggregation drugs application scheme can be adjusted according to the patients’situation, or interventional remedy, surgical combined treatment, effective technical level of operators can be used for effective prevention. Key words: Intracranial aneurysm; Subarachnoid hemorrhage; Stent-assisted embolization