Abstract: Objective To evaluate the safety and efficacy of endovascular treatment of paraclinoid unruptured intracranial aneurysms (UIA). Methods Patients with paraclinoid UIA admitted to Department of Neurosurgery of Tangdu Hospital, Air Force Military Medical University from January 2017 to December 2019 were included in this retrospective analysis. The collected data included the baseline data, imaging data, the results of aneurysms embolization, periprocedural complications and the proportion of poor prognosis (mRS>2 points). The factors associated with postprocedural recurrence of aneurysms were analyzed. Results A total of 176 patients were included in this analysis, with a mean age of 54.7±9.6 years (aged 23-74 years) and 32 males (18.2%). Among 184 aneurysms, Raymond Ⅰ 151 (82.1%), Raymond Ⅱ 31 (16.8%) and Raymond Ⅲ 2 (1.1%). Periprocedural complications occurred in 11 cases (6.3%); 5 cases (3.3%) of the 151 patients with clinical follow-up had poor prognosis; 8 cases (7.0%) of the 114 patients with imaging follow-up had aneurysms recurrence. Univariate analysis showed that incomplete embolization was associated with aneurysms recurrence (P =0.004). Conclusions Endovascular treatment of paraclinoid UIA was generally safe and effective, and complete embolization of paraclinoid UIA should be attempted.

Key words: Unruptured intracranial aneurysm; Endovascular treatment; Recurrence

摘要： 目的 评估血管内治疗床突旁未破裂颅内动脉瘤（unruptured intracranial aneurysm，UIA）的安全性和 有效性。 方法 回顾性纳入2017年1月-2019年12月于空军军医大学唐都医院神经外科连续收治的床突旁UIA 患者。收集患者的基线资料和影像学资料，统计动脉瘤栓塞结果、围手术期并发症发生情况及预后 不良（mRS>2分）比例；分析与动脉瘤术后复发的相关因素。 结果 最终纳入176例床突旁UIA患者，年龄23～74岁，平均54.7±9.6岁，其中男性32例（18.2%）。184 枚接受血管内治疗动脉瘤Raymond Ⅰ级151枚（82.1%），Raymond Ⅱ级31枚（16.8%），Raymond Ⅲ级2 枚（1.1%）。176例患者围手术期并发症发生11例（6.3%）；151例随访患者中预后不良5例（3.3%）；影 像学随访114例患者中复发8例（7.0%）。单因素分析结果显示，未完全栓塞与动脉瘤术后复发存在一 定关系（P＝0.004）。 结论 床突旁UIA血管内治疗总体为安全和有效的，在治疗床突旁UIA时，应尽量完全栓塞。

关键词: 未破裂颅内动脉瘤; 血管内治疗; 复发