Endovascular Treatment of Ruptured Intracranial Aneurysms
in Patients Aged 75 Years and Older: Short Term Clinical
Outcome of 26 Patients

, Jae-hwan Chung1; , Hyun Park1; ,; , Chul-Hee Lee1; ,  In Sung Park1,2,; , Jin-MyungJung1; ,  Jong-Woo Han1; ,

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2014;10(2):87-91.
Published online December 30, 2014.

Endovascular Treatment of Ruptured Intracranial Aneurysms in Patients Aged 75 Years and Older: Short Term Clinical Outcome of 26 Patients

Jae-hwan Chung1 , Hyun Park1 , , Chul-Hee Lee1 , In Sung Park1,2, , Jin-MyungJung1 , Jong-Woo Han1 ,

¹Department of Neurosurgery, Gyeongsang National University, School of Medicine, Jinju, ²Gyeongsang Institute of Health Science, Jinju, Korea

Abstract

Objective
Endovascular coil embolization is increasingly being used for the treatment of intracranial aneurysms, especially in elderly patients. However, the management of ruptured intracranial aneurysms remains controversial and there have been no studies regarding endovascular treatment of ruptured cerebral aneurysms in extremely old patients (≥75 years). Thus, in this study, we assessed short term clinical outcomes in elderly patients aged 75 years or older with ruptured intracranial aneurysms treated by endovascular coil embolization.
Methods
From January 2010 to December 2012, we treated 26 patients with ruptured cerebral aneurysms aged over 75 by endovascular coil embolization. We retrospectively evaluated clinical outcomes of these patients with initial and follow-up modified Rankin scale (mRS) and magnetic resonance angiographs.
Results
Total 26 patients with ruptured aneurysms were treated by endovascular coil embolization. Successful embolizations without complications were completed in 25 cases. One patient had a procedure-related event, a non-symptomatic thromboembolic complication. Initial neurologic status (Hunt and Hess grade) and radiologic severity (Fisher grade) were significant prognostic factor for initial clinical outcome. On discharge and one-year follow-up, almost half of patients showed fair to excellent outcome (mRS 1 to 3). We obtained follow-up angiographic images in five patients, all showed no recanalization or regrowth of the aneurysm.
Conclusion
In patients over 75 years old with ruptured intracranial aneurysms, treatment with endovascular coil embolization can be safe and successful. Initial neurologic, radiologic status were important in predicting the neurological outcome.

Key Words: Endovascular treatmentㆍSubarachnoid hemorrhageㆍAged