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KMID : 1005420200220040237
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Journal of Cerebrovascular and Endovascular Neurosurgery
2020 Volume.22 No. 4 p.237 ~ p.244
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Endovascular coil embolization for unruptured intracranial aneurysms in patients over 80 years of age
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Lee Seok-Won
Kwon Hyon-Jo
Jeong Eun-Oh
Koh Hyeon-Song
Kim Kyung-Hwan
Choi Seung-Won
Kim Seon-Hwan
Youm Jin-Young
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Abstract
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Objective: As the average life span in modern society continues to increase, much interest is focused on high-risk procedures in elderly patients, including major surgical operations. We investigated the results of endovascular coiling of unruptured intracranial aneurysms (UIA) in patients over 80 years of age.
Methods: We retrospectively analyzed 39 patients aged over 80 years who underwent coil embolization for UIA between April 2007 and April 2019 at our hospital.
Results: Complete occlusion on digital subtraction angiography (DSA) immediately after surgery was performed in 44 (84.6%) of 52 cases of cerebral aneurysms. Four patients (7.7%) had residual aneurysmal necks, and four (7.7%) had contrast flow in the aneurysmal sac. Follow-up magnetic resonance angiography (mean: 8.2 months) was performed in 37 aneurysms in 24 patients. There was evidence of blood flow in the neck in seven cases (18.9%) and aneurysm in two cases (5.4%). Follow-up DSA (mean: 20.5 months) was performed in 14 aneurysms in 11 patients, and 11 aneurysms (78.6%) had complete occlusion, 1 aneurysm (7.1%) had an aneurysmal neck, and 2 aneurysms (14.3%) had contrast filling into the aneurysmal sac. Coil embolization procedure-related complications occurred in 3 patients (7.7%). Cerebral infarction occurred in 1 (2.6%), arterial dissection in 1 (2.6%), and hypoesthesia in 1 (2.6%).
Conclusions: Active treatment of UIA in elderly patients over 80 years of age through endovascular coil embolization can be considered.
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KEYWORD
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Elderly, Endovascular procedures, Intracranial aneurysm, Coil
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