Abstract:
ObjectiveTo investigate the risk factors of cerebral arteriovenous malformation(AVM) compolicated with proximal intracranial aneurysm(APIA) and its treatment.
MethodsThe clinical data of 352 patients with AVM were retrospectively analyzed, and the patents were divided into the non-APIA group(321 cases) and APIA group(31 cases) according to the presence or absence of APIA.The gender, age, blood supply and size of AVM, drainage vein type, bleeding and bleeding site were compared between two groups, and the multivariate analysis was conducted.The patients with AVM complicated with APIA were divided into the endovascular treatment group, surgery treatment group and surgery combined with endovascular treatment group according to different treatment methods.The blood supplying artery, maximum diameter of aneurysm, maximum dimeter of AVM, post-treatment rebleeding rate and GOS prognosis score were compared among three groups.
ResultsThe age of patients in APIA group was higher than that in non-APIA group(P < 0.01), and the rate of blood supply of posterior circulation in APIA group was 51.6%(16/31), which was significantly higher than that in non-APIA group(22.7%, 73/321)(P < 0.05).The results of multivariate analysis showed that the age and AVM blood supply were the independent risk factors of APIA.The differences of the aneurysm supplying artery, maximum diameter of aneurysm, maximum diameter of AVM, postoperative rebleeding rate and GOS prognosis score among endovascular treatment, surgery treatment and surgery combined with endovascular treatment groups were not statistically significant(P > 0.05).
ConclusionsThe older the patient is, the more likely APIA will occur, and the AVM supplied by the posterior circulation is more likely to be complicated with APIA.Under the guidance of the principle of priority treatment of aneurysms, the surgery treatment, endovascular treatment and surgery combined with endovascular treatment can achieve a better prognosis.