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Prognostic risk factors in endovascular interventional therapy for unruptured intracranial aneurysm after radiotherapy
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N. Sun   , J. Ma , J. Wang , D. Zhang , C. Yu , Y. Li |
| Department of Neurosurgery, Jilin Province FAW General Hospital, Changchun, 130000, China , liyuan39158461@163.com |
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Abstract: (14 Views) |
Background: This study aimed to identify prognostic risk factors and emerging biomarkers linked to poor outcomes in patients with unruptured intracranial aneurysms (UIA) who underwent endovascular therapy after cranial radiotherapy. Materials and Methods: We retrospectively analyzed 120 UIA patients treated between January 2018 and December 2021. All had previously received cranial radiotherapy with a median cumulative dose of 50 Gy (range: 30-60 Gy) using intensity-modulated radiotherapy (IMRT) or stereotactic radiosurgery (SRS). The median interval between radiotherapy and UIA diagnosis was 5 years (range: 1-15 years). Endovascular interventions included microcoil embolization, stent-assisted, or balloon-assisted techniques. Preoperative and postoperative levels of soluble TREM2 (sTREM2), neurofilament light chain (NfL), and matrix metalloproteinase-9 (MMP-9) were assessed via ELISA. Clinical variables-including hypertension grade, Hunt-Hess grade, and CT-Fisher grade-were analyzed using univariate and multivariate logistic regression to identify independent predictors of poor prognosis, defined as a modified Rankin Scale (mRS) score of 3-6. Results: Poor prognosis occurred in 25.83% of patients. Radiotherapy dose >50 Gy was independently associated with poor outcomes (OR=2.15, P=0.023). Hypertension grade (OR=18.02, P=0.004), Hunt-Hess grade (OR = 14.71, P = 0.017), elevated sTREM2 (OR=3.37, P=0.011), and MMP-9 (OR=6.68, P=0.005) were also significant predictors. Conclusion: Higher radiation dose, hypertension, neurological severity, and elevated inflammatory biomarkers independently predict adverse outcomes after endovascular therapy in post-radiotherapy UIA patients, supporting their use in risk stratification models. |
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| Keywords: Intracranial aneurysm, endovascular procedures, radiotherapy, biomarkers, matrix metalloproteinase 9. |
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Full-Text [PDF 803 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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