Journal of Korean Society of Geriatric Neurosurgery 2017;13(1):13-18.
Published online June 30, 2017.
Efficacy and Safety of Endovascular Treatment for Unruptured Complex Aneurysms in Both Elderly and Non-elderly Patients
Hyun-Nam Seo , Cheol-Young Lee , Jin-Ho Seo , Jihye Song , Jong-Hyun Kim , Hyun-Woo Kim
Department of Neurosurgery, Konyang University College of Medicine, Daejeon, Korea
Abstract
Objective
Recent developments in endovascular therapy have led to a new approach in the treatment of complex aneurysms. This study aimed to evaluate the efficacy and safety of the endovascular approach for treating unruptured complex aneurysms, in both elderly and non-elderly patients, based on our clinical experience.
Methods
We retrospectively evaluated 117 patients with unruptured complex aneurysms who were treated with single conventional coiling, stent-assisted coiling, double-catheter technique, or a combined method over a 4-year period.
Results
Among the study subjects, 63 (53.8%) were in the elderly group and 54 (46.2%) were in the non-elderly group; the mean age was 62.2 years (range, 27-86 years). There were 109 (93.2%), 20 (17.1%), and 12 (10.3%) cases of wide-neck aneurysm, micro-aneurysm, and aneurysms that incorporated the branch arteries, respectively. The average neck width was 3.9 mm; average axis/neck ratio, 1.2; and average long diameter, 5.2 mm. A total of 111 (94.9%) aneurysms were located in the anterior circulation. The overall complete occlusion rate was 83.8%, and the occlusion rates for single conventional coiling, stent-assisted coiling, double-catheter technique, and combined method were 85.3%, 87.7%, 75%, and 66.7%, respectively. Two (1.7%), 2 (1.7%), 1 (0.9%), and 1 (0.9%) patient presented with aneurysmal rupture, temporary weakness, thromboembolic complications, and procedure failure, respectively. Seven (6.0%) cases of recanalization were detected on follow-up angiogram.
Conclusion
A high occlusion rate and low incidence of complications was achieved with endovascular coil embolization in both elderly and non-elderly patients. Long-term studies are warranted to confirm the usefulness of endovascular therapy.
Key Words: Aneurysm, Endovascular procedure, Therapeutic embolization


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