Related risk factors for progressive occlusion of intracranial aneurysms treated with low-profile visualized intraluminal support device stent in mid-term follow up

Abstract

Objective To analyze the angiographic results of intracranial aneurysms without complete embolization immediately after low-profile visualized intraluminal support device (LVIS) stent at mid-term follow up, and explore the risk factors for healing of partial occluded aneurysms. Methods One hundred and sixty-one patients with intracranial aneurysms treated by LVIS stent embolization in our hospital from December 2014 to December 2018 were selected; 193 aneurysms in total, including 93 un-ruptured aneurysms and 100 ruptured aneurysms, were noted. DSA was performed immediately after operation to evaluate the degrees of aneurysm embolization according to Raymond grading criteria. The embolization degrees of aneurysms were compared at 8 months after surgery and immediately after surgery, and the healing of aneurysms (Raymond grading 1) was calculated. Univariate Logistic regression analysis and multivariate Logistic regression analysis (forward maximum likelihood ratio method) were used to screen the risk factors for healing of incomplete aneurysm embolization. Results The embolization degrees immediately after surgery were as follows: 78 were with Raymond grading 1, 54 with Raymond grading 2, and 61 with Raymond grading 3; complete aneurysm embolization were noted in 78 aneurysms (40.41%) and incomplete aneurysm embolization were noted in 115 (59.59%). Follow up (8 months after surgery) results indicated that, of the 193 aneurysms, 171 were with Raymond grading 1, 10 with Raymond grading 2, and 12 with Raymond grading 3; there were 171 aneurysms (88.60%) having complete aneurysm embolization and 22 (11.40%) having incomplete aneurysm embolization. In the aneurysms having incomplete aneurysm embolization immediately after surgery, the healing rate was 81.74% (94/115). Univariate Logistic regression analysis showed that hypertension, diabetes mellitus, posterior circulation aneurysm, dissecting aneurysm, body-neck ratio and embolization degrees immediately after surgery were risk factors for healing of aneurysms (P<0.05). Multivariate Logistic regression analysis revealed that posterior circulation aneurysm and diabetes mellitus were independent risk factors for healing of aneurysms (P<0.05). The area under the curve of receiver operating characteristic curve of the regression model was 0.755, indicating that the prediction efficiency of the regression model was moderate. Conclusion Treatment of intracranial aneurysms with LVIS stent is effective, and the complete occlusion rate is high, even in the aneurysms with incomplete embolization immediately after surgery; aneurysms located in the posterior circulation and associated with diabetes can affect the treatment of aneurysms. Key words: Intracranial aneurysm; Endovascular treatment; LVIS stent; Embolization