Clinical Outcome of Endovascular Treatment of Cerebral Aneurysms in Elderly Patients

Lee, Kyung Kyu; Woo, Hyun Jin; Kang, Dong Hun; Park, Jae Chan; Kim, Yong Sun

Abstract

OBJECTIVE
Subarachnoid hemorrhage (SAH) is known to have a high mortality rate and increase incidence by aging process. To old aged patients, treatment of cerebral aneurysm is controversial due to multiple factors, regarding underlying disease, life expectancy and treatment risk. We reviewed treatment outcome of the patients older than 65 years who had cerebral aneurysm (s) by using endovascular technique.
METHODS
Between 2000 and 2009, 177 patients who aged over 65 years were treated by endovascular management. Among them, 116 patients were presented with SAH and 61 patients were unruptured aneurysm. In SAH group, treatment outcome was evaluated by Glasgow Outcome Scale (GOS) at discharge and modified Rankin Scale (mRS) at 3 months. In unruptured aneurysm group, procedure complication and recurrence of the cerebral aneurysm were evaluated.
RESULTS
177 patients harbored 209 aneurysms in total. GOS for the patients with SAH at discharge was good recovery (n=82, 71%), mild disability (n=7, 6%), severe disability (n=18, 15%), vegetative (n=3, 3%) and death (n=6, 5%). Three months mRS was good condition (mRS 0-2) in 83 patients, poor condition (mRS 3-5) in 26 and death in 1. Regarding the factors related with good recovery in SAH groups, initial Hunt and Hess grade showed statistical significance. In the group of unruptured aneurysm, only 1 patient (1.6%) had a procedure rupture and related in symptomatic intracerebral hemorrhage.
CONCLUSION
Based upon our data, coil embolization of cerebral aneurysm was relatively safe and effective to older patients.