Risk factors and prognostic analysis of rerupture in the embolization of ruptured intracranial aneurysms

Objective To investigate the risk factors for rerupture and prognosis of patients in the embolization of ruptured intracranial aneurysms. Methods From August 2013 to August 2015, the clinical data of 151 patients with ruptured intracranial aneurysm treated with embolization and admitted to the Department of Neurosurgery, the Affiliated Hospital of Southwest Medical University were analyzed retrospectively. Eleven patients (7.3%) had intraprocedural rerupture. Results Univariate analysis showed that small aneurysms (P=0.034) and interim operation (P=0.029) had greater risk of intraprocedural rerupture. Multivariate analysis showed that small aneurysms (OR, 5.51, 95% CI 1.12-27.13, P=0.036)and interim operation (OR, 5.03, 95% CI 1.24-20.34, P=0.023) were the independent risk factors for intraprocedural rerupture. After procedure, the patients with intraprocedural rerupture had a higher incidence of symptomatic cerebral vasospasm (45.5% vs. 13.6%, P=0.016), and the incidence of poor prognosis in these patients was significantly higher than those without having intraprocedural rerupture (36.4% vs. 9.3%, P=0.022). Conclusions In interventional embolization of ruptured intracranial aneurysms, intraprocedural rerupture is a common surgical complication. It seriously affects the prognosis of the patients. Small aneurysms and interim operation may be associated with the occurrence of intraprocedural rerupture. Intraprocedural rerupture will result in the increased incidence of symptomatic cerebral vasospasm in patients after procedure. Key words: Intracranial aneurysm; Aneurysm, ruptured; Embolization, therapeutic; Risk factors; Prognosis