We report our experience in the endovascular treatment with detachable platinum coils of ruptured or symptomatic unruptured cerebral aneurysms in 61 patients aged 70-82 years. Complete occlusion was achieved in 38, subtotal in 17 and partial in one. The treatment failed in five patients. Clinical follow-up was performed in all patients for 8 months to 8 years. No bleeding occurred during the follow-up period. Outcome was favourable in 63% of the patients. When we compared the outcome of elderly patients with those of younger age endovascularly treated in the same period of time, we found a significantly higher frequency of poorer outcome in the elderly group (chi(2) = 9.084; P = 0.011). The frequency of favourable outcome in the elderly was significantly lower than in the younger group for H-H IV-V (chi(2) = 9.299; P = 0.010). The most important factor influencing the outcome was not age itself, but primary clinical condition on admission. The therapy of symptomatic aneurysms in elderly patients should not be purely conservative--a direct approach of the aneurysm should be considered. Endovascular treatment whenever possible seems to be a good alternative to surgery.
Endovascular treatment of cerebral aneurysms in elderly patients
BRADAC, Gianni Boris;BERGUI, Mauro;FONTANELLA, Marco Maria
2005-01-01
Abstract
We report our experience in the endovascular treatment with detachable platinum coils of ruptured or symptomatic unruptured cerebral aneurysms in 61 patients aged 70-82 years. Complete occlusion was achieved in 38, subtotal in 17 and partial in one. The treatment failed in five patients. Clinical follow-up was performed in all patients for 8 months to 8 years. No bleeding occurred during the follow-up period. Outcome was favourable in 63% of the patients. When we compared the outcome of elderly patients with those of younger age endovascularly treated in the same period of time, we found a significantly higher frequency of poorer outcome in the elderly group (chi(2) = 9.084; P = 0.011). The frequency of favourable outcome in the elderly was significantly lower than in the younger group for H-H IV-V (chi(2) = 9.299; P = 0.010). The most important factor influencing the outcome was not age itself, but primary clinical condition on admission. The therapy of symptomatic aneurysms in elderly patients should not be purely conservative--a direct approach of the aneurysm should be considered. Endovascular treatment whenever possible seems to be a good alternative to surgery.
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