Health-related quality of life outcomes and influencing factors in patients with unruptured intracranial aneurysms after endovascular treatment.

BACKGROUND: Health-related quality of life (HRQoL) is an important indicator when evaluating prognosis and disease-related treatments. Our current knowledge of the HRQoL outcomes of unruptured intracranial aneurysm (UIA) patients treated by the endovascular intervention appeared to be very limited. To fill this gap, the present study investigated the HRQoL outcomes and identified the influencing factors in UIA patients treated by endovascular intervention. METHODS: We conducted a single-center cross-sectional study on patients who underwent endovascular treatment for UIAs. HRQoL outcomes were assessed by the 36-item Short Form Health Survey (SF-36). The SF-36 results of the Chinese reference population were used as the reference data. The independent variables with a univariate analysis result of P < 0.05 were included in the multivariate analysis. Finally, multivariable linear regression analysis was performed to identify the factors influencing HRQoL. Bonferroni correction was utilized for multiple testing correction. RESULTS: A total of 200 patients (83 males and 117 females, mean age of 55.2 ± 9.48 years) with UIAs treated by endovascular intervention were enrolled. The scores of SF-36 in 8 domains for UIA patients treated by endovascular intervention did not all reach the average level of the Chinese reference population after an average recovery period of 30.67 ± 8.6 months. Ischemic cerebrovascular disease history, advanced age, and mRS progression at discharge were independent risk factors of HRQoL for UIA patients treated by endovascular intervention, but physical exercise at least once a week and daily sleep time no < 6 h were independent protective factors. CONCLUSION: The HRQoL of UIA patients treated by the endovascular intervention was decreased to varying degrees compared with those of the Chinese reference population. The influencing factors of HRQoL explored by this study provide insights for improving the clinical management and daily lives of these patients. HRQoL assessment should be included in future aneurysm prognostic studies to provide better evidence.

Analysis of the wall thickness of intracranial aneurysms: Can computational fluid dynamics detect the translucent areas of saccular intracranial aneurysms and predict the rupture risk preoperatively?

Background and purpose: The translucent area on the surface of intracranial aneurysms (IAs) is associated with rupture risk. In the present study, the Polyflow module of the Ansys software was used to simulate and analyze the thickness of the aneurysm wall to detect whether it was "translucent" and to assess the rupture risk. Methods: Forty-five patients with 48 IAs who underwent microsurgery were retrospectively reviewed. The medical records, radiographic data, and intraoperative images of the patients were collected. The image data were analyzed using computational fluid dynamics (CFD) simulations to explore the relationship between the simulated thickness of the aneurysm wall, the translucent area, and the rupture point of the real aneurysm's surface to predict the rupture risk and provide a certain reference basis for clinical treatment. Results: The Polyflow simulation revealed that the location of the minimum extreme point of the simulated aneurysm wall thickness was consistent with the translucent area or rupture point on the surface of the real aneurysm. There was a downward trend in the correlation between the change rate (IS) in the wall area and volume during aneurysm growth and rupture. Ruptured aneurysms have a greater inhomogeneity coefficient Iδ than the unruptured ones. In the unruptured group, translucent aneurysms also had greater inhomogeneity coefficients Iδ and more significant thickness changes (multiple IBA) than non-translucent ones. Conclusions: The Ansys software Polyflow module could detect whether the unruptured aneurysms were translucent and predict the rupture risk and rupture point. Clinical trial registration: https://clinicaltrials.gov/, Identifier, NCT03133624.

Microsurgical and Endovascular Treatment Outcomes in Pericallosal Artery Aneurysms: A Single Center Retrospective Analysis.

AIM: To summarize the clinical outcomes, follow-up results and to discuss the optimal therapeutic strategy for pericallosal artery aneurysms (PAAs). MATERIAL AND METHODS: From January 2013 to May 2017, the charts of 49 patients with PAAs, representing 2.43% of 2,018 consecutive patients with intracranial aneurysms (IAs) were reviewed. The clinical and radiological data of these patients were retrospectively analyzed. RESULTS: There were no technical failures in the clipping group, but one patient in the coiling group presented rebleeding during the operation, resulting in a poor prognosis. Although the difference was not significant, the coiling group had a better complete recovery rate than the clipping group [overall: coiling, n=20 (87.0%) vs clipping, n=11 (68.8%), p=0.33; unruptured PAAs: coiling, n=12 (92.3%) vs clipping, n=5 (83.3%); ruptured PAAs: coiling, n=8 (80%) vs clipping, n=6 (60%), p=0.63]. One patient in the coiling group exhibited recurrence. No patients experienced rebleeding during the follow-up period in either group. CONCLUSION: In our study, both endovascular coiling and microsurgery were technically feasible and achieved favorable clinical outcomes in patients with PAAs. Longer radiological follow-up is necessary. Patients should be evaluated by a multidisciplinary team prior to determining the optimal treatment modality.