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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms

Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
DOI: 10.1136/jim-2021-002230 Published 22 June 2022
Junjie Luo
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Chengmou Wang
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Yongjian Dai
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Xin Chen
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Xuecheng Tian
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Yi Lin
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Xinguo Qu
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Tables

  • Table 1

    Patient characteristics

    Patient characteristicsStudy group (n=65)Control group (n=65)χ2/tP value
    Age at treatment (years)48.93±8.9148.89±8.450.0380.846
    Female sex, n (%)46 (71)46 (72)0.0260.979
    Left side, n (%)33 (51)34 (52)0.0310.861
    Smoking history, n (%)21 (32)18 (28)0.3300.566
    History of arterial hypertension, n (%)48 (74)51 (78)0.3810.537
    Mean GCS score14.01±1.2314.92±1.19−1.4600.147
    Hunt and Hess Scale, n (%)0.1350.713
     Grade 043 (66)41 (63)
     Grade 122 (34)24 (37)
    Modified Fisher classification, n (%)
     Grade 021 (32)17 (26)2.7570.599
     Grade 19 (14)6 (9)
     Grade 213 (20)11 (17)
     Grade 315 (23)13 (20)
     Grade 47 (11)8 (12)
    Site of aneurysm, n (%)
     Posterior communicating artery30 (46)32 (49)1.0250.599
     Middle cerebral artery9 (14)12 (18)
     Anterior communicating artery26 (40)21 (32)
    Shape of aneurysm, n (%)
     Cystic41 (63)43 (66)0.8360.841
     Spindle11 (17)14 (21)
     Lobulated12 (18)9 (14)
     Multiple forms21 (32)23 (35)
    Diameter of aneurysm, n (%)
     <5 mm41 (63)40 (62)0.5370.764
     5–15 mm21 (32)20 (31)
    • GCS, Glasgow Coma Scale.

  • Table 2

    Comparison of GOS grading

    GOS gradeStudy (n=65)
    n (%)
    Control (n=65)
    n (%)
    χ2P value
    Grade 153 (82)23 (35)28.509<0.001*
    Grade 210 (15)21 (32)5.1250.024
    Grade 32 (3)15 (23)11.4370.001*
    Grade 40 (0)6 (9)6.2900.012*
    Grade 500
    • *Difference is statistically significant at p<0.05.

    • GOS, Glasgow Outcome Scale.

  • Table 3

    Comparison of activity ability and indicators of brain injury

    Study group (n=65)Control group (n=65)tP value
    Mean activity score
     Before treatment43.59±4.2944.83±4.02−1.70.092
     After treatment73.29±6.3966.94±5.985.85<0.001*
    Mean NSE, µg/L
     Before treatment41.98±6.9342.12±7.01−0.1150.909
     After treatment11.02±4.0819.38±3.87−11.986<0.001*
    Mean S100β, µg/L
     Before treatment18.98±2.3919.08±2.41−0.2380.812
     After treatment4.03±0.388.38±0.42−61.92<0.001*
    • *Difference is statistically significant at p<0.05.

    • NSE, neuron-specific enolase; S100β, astrocyte-derived protein.

  • Table 4

    Comparison of results of follow-up

    Study group
    (n=65)
    Control group
    (n=65)
    χ2/tP value
    Postoperative hospital stay (days)17.65 (1.29)23.0 (1.32)−23.501<0.001*
    Pulmonary infection, n (%)12 (18)28 (43)9.2440.002*
    Intracranial infection, n (%)2 (3)42 (64)54.968<0.001*
    Brain herniation, n (%)4 (6)5 (8)0.1190.730
    • *Difference is statistically significant at p<0.05.

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Journal of Investigative Medicine: 70 (5)
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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms
Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
Journal of Investigative Medicine Jun 2022, 70 (5) 1273-1279; DOI: 10.1136/jim-2021-002230

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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms
Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
Journal of Investigative Medicine Jun 2022, 70 (5) 1273-1279; DOI: 10.1136/jim-2021-002230
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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms
Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
Journal of Investigative Medicine Jun 2022, 70 (5) 1273-1279; DOI: 10.1136/jim-2021-002230
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