Risk factors for delayed cerebral infarction after intracranial aneurysm clipping

Abstract

Objective To analyze the risk factors and clinical significance of delayed cerebral infarction (DCI) after intracranial aneurysm (IA) clipping. Methods A retrospective analysis was performed on the clinical data of IA patients admitted to the First Affiliated Hospital of Chongqing Medical University from January 2015 to December 2019. A total of 480 patients undergoing aneurysm clipping were included. The patients with DCI were set as the observation group (n=42), and those without as the control group (n=438). The risk factors for DCI were screened by univariate and multivariate logistic regression analysis. Results Univariate analysis showed that female (P=0.029), small aneurysms (P=0.001), intraoperative aneurysm rupture (IAR) (P=0.007) and cerebral vasospasm (P < 0.001) were risk factors for DCI after IA clipping, while smoking history (P=0.020) was a protective factor. Multivariate logistic regression analysis indicated that small aneurysms (P=0.002, OR=2.951, 95%CI: 1.478~5.893), IAR (P=0.004, OR=7.829, 95%CI: 1.924~31.854) and cerebral vasospasm (P < 0.001, OR=5.919, 95%CI: 2.887~12.134) were postoperative independent risk factors for DCI. Conclusion Proper treatment of small aneurysms, proactive prevention of IAR and treatment of cerebral vasospasm can prevent the occurrence of DCI effectively, and thereby reduce the disability rate and improve the prognosis of patients.

Keywords

• intracranial aneurysm
• clipping
• delayed cerebral infarction
• risk factors