Treatment results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms in elderly patients

Background and purposeWe report the results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms (UIAs) in elderly patients (≥65 years).MaterialsThere were 375 elderly patients with 400 asymptomatic UIAs. Patients were divided into two groups: group A included patients...

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Veröffentlicht in:Journal of neurointerventional surgery 2015-09, Vol.7 (9), p.660-665
Hauptverfasser: Oishi, Hidenori, Yamamoto, Munetaka, Nonaka, Senshu, Shimizu, Takashi, Yoshida, Kensaku, Mitsuhashi, Takashi, Arai, Hajime
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container_end_page 665
container_issue 9
container_start_page 660
container_title Journal of neurointerventional surgery
container_volume 7
creator Oishi, Hidenori
Yamamoto, Munetaka
Nonaka, Senshu
Shimizu, Takashi
Yoshida, Kensaku
Mitsuhashi, Takashi
Arai, Hajime
description Background and purposeWe report the results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms (UIAs) in elderly patients (≥65 years).MaterialsThere were 375 elderly patients with 400 asymptomatic UIAs. Patients were divided into two groups: group A included patients aged 65–74 years and group B patients aged ≥75 years.ResultsEndovascular procedures were completed in 97.8% of patients. Immediate anatomical outcomes showed complete occlusion in 53.7%, residual neck in 18.9%, and residual aneurysm in 27.4%. Anatomical follow-ups (mean 36.3±28.1 months) were unchanged in 55.7%, improved in 22.6%, minor recurrence in 11.5%, and major recurrence in 10.2%. Procedure related complications occurred in 31 patients (8.3%). 15 patients had ischemic and 10 hemorrhagic complications. Retreatments were performed in 16 patients (4.3%). Among 366 patients technically completed, 363 (99.2%) showed a favorable clinical outcome (modified Rankin Scale (mRS) score 0 at 30 days. The latest clinical follow-up outcomes showed: mRS score 0 in 362 patients; mRS score 1 in one; mRS score 3 in one; mRS score 4 in one; and mRS score 5 in one patient. Permanent morbidity and mortality rates were 1.1% and 0%, respectively. There were no statistically significant differences in gender, comorbidities, aneurysm size, neck width, dome-to-neck ratio, immediate anatomical outcomes, anatomical follow-up outcomes, or procedure related complications between the groups.ConclusionsEndosaccular coil embolization is safe and feasible for elderly patients with asymptomatic UIAs. Old age itself should not be a contraindication.
doi_str_mv 10.1136/neurintsurg-2014-011305
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Patients were divided into two groups: group A included patients aged 65–74 years and group B patients aged ≥75 years.ResultsEndovascular procedures were completed in 97.8% of patients. Immediate anatomical outcomes showed complete occlusion in 53.7%, residual neck in 18.9%, and residual aneurysm in 27.4%. Anatomical follow-ups (mean 36.3±28.1 months) were unchanged in 55.7%, improved in 22.6%, minor recurrence in 11.5%, and major recurrence in 10.2%. Procedure related complications occurred in 31 patients (8.3%). 15 patients had ischemic and 10 hemorrhagic complications. Retreatments were performed in 16 patients (4.3%). Among 366 patients technically completed, 363 (99.2%) showed a favorable clinical outcome (modified Rankin Scale (mRS) score &lt;1) at 30 days. The remaining three patients showed a worsening of mRS &gt;0 at 30 days. The latest clinical follow-up outcomes showed: mRS score 0 in 362 patients; mRS score 1 in one; mRS score 3 in one; mRS score 4 in one; and mRS score 5 in one patient. Permanent morbidity and mortality rates were 1.1% and 0%, respectively. There were no statistically significant differences in gender, comorbidities, aneurysm size, neck width, dome-to-neck ratio, immediate anatomical outcomes, anatomical follow-up outcomes, or procedure related complications between the groups.ConclusionsEndosaccular coil embolization is safe and feasible for elderly patients with asymptomatic UIAs. Old age itself should not be a contraindication.</description><identifier>ISSN: 1759-8478</identifier><identifier>EISSN: 1759-8486</identifier><identifier>DOI: 10.1136/neurintsurg-2014-011305</identifier><identifier>PMID: 25034903</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Aneurysms ; Asymptomatic Diseases - therapy ; Clinical outcomes ; Embolization, Therapeutic - methods ; Female ; Hemorrhagic Stroke ; Humans ; Intracranial Aneurysm - therapy ; Male ; Medical imaging ; Morbidity ; Mortality ; Thromboembolism ; Treatment Outcome</subject><ispartof>Journal of neurointerventional surgery, 2015-09, Vol.7 (9), p.660-665</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2015 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b554t-673fad54d14f79ddda8f9572825b1b22b4c8e55c41a85d4a20f58aa779243c683</citedby><cites>FETCH-LOGICAL-b554t-673fad54d14f79ddda8f9572825b1b22b4c8e55c41a85d4a20f58aa779243c683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jnis.bmj.com/content/7/9/660.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://jnis.bmj.com/content/7/9/660.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,314,780,784,885,3194,23570,27923,27924,77371,77402</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25034903$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oishi, Hidenori</creatorcontrib><creatorcontrib>Yamamoto, Munetaka</creatorcontrib><creatorcontrib>Nonaka, Senshu</creatorcontrib><creatorcontrib>Shimizu, Takashi</creatorcontrib><creatorcontrib>Yoshida, Kensaku</creatorcontrib><creatorcontrib>Mitsuhashi, Takashi</creatorcontrib><creatorcontrib>Arai, Hajime</creatorcontrib><title>Treatment results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms in elderly patients</title><title>Journal of neurointerventional surgery</title><addtitle>J Neurointerv Surg</addtitle><description>Background and purposeWe report the results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms (UIAs) in elderly patients (≥65 years).MaterialsThere were 375 elderly patients with 400 asymptomatic UIAs. Patients were divided into two groups: group A included patients aged 65–74 years and group B patients aged ≥75 years.ResultsEndovascular procedures were completed in 97.8% of patients. Immediate anatomical outcomes showed complete occlusion in 53.7%, residual neck in 18.9%, and residual aneurysm in 27.4%. Anatomical follow-ups (mean 36.3±28.1 months) were unchanged in 55.7%, improved in 22.6%, minor recurrence in 11.5%, and major recurrence in 10.2%. Procedure related complications occurred in 31 patients (8.3%). 15 patients had ischemic and 10 hemorrhagic complications. Retreatments were performed in 16 patients (4.3%). Among 366 patients technically completed, 363 (99.2%) showed a favorable clinical outcome (modified Rankin Scale (mRS) score &lt;1) at 30 days. The remaining three patients showed a worsening of mRS &gt;0 at 30 days. The latest clinical follow-up outcomes showed: mRS score 0 in 362 patients; mRS score 1 in one; mRS score 3 in one; mRS score 4 in one; and mRS score 5 in one patient. Permanent morbidity and mortality rates were 1.1% and 0%, respectively. There were no statistically significant differences in gender, comorbidities, aneurysm size, neck width, dome-to-neck ratio, immediate anatomical outcomes, anatomical follow-up outcomes, or procedure related complications between the groups.ConclusionsEndosaccular coil embolization is safe and feasible for elderly patients with asymptomatic UIAs. 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Patients were divided into two groups: group A included patients aged 65–74 years and group B patients aged ≥75 years.ResultsEndovascular procedures were completed in 97.8% of patients. Immediate anatomical outcomes showed complete occlusion in 53.7%, residual neck in 18.9%, and residual aneurysm in 27.4%. Anatomical follow-ups (mean 36.3±28.1 months) were unchanged in 55.7%, improved in 22.6%, minor recurrence in 11.5%, and major recurrence in 10.2%. Procedure related complications occurred in 31 patients (8.3%). 15 patients had ischemic and 10 hemorrhagic complications. Retreatments were performed in 16 patients (4.3%). Among 366 patients technically completed, 363 (99.2%) showed a favorable clinical outcome (modified Rankin Scale (mRS) score &lt;1) at 30 days. The remaining three patients showed a worsening of mRS &gt;0 at 30 days. The latest clinical follow-up outcomes showed: mRS score 0 in 362 patients; mRS score 1 in one; mRS score 3 in one; mRS score 4 in one; and mRS score 5 in one patient. Permanent morbidity and mortality rates were 1.1% and 0%, respectively. There were no statistically significant differences in gender, comorbidities, aneurysm size, neck width, dome-to-neck ratio, immediate anatomical outcomes, anatomical follow-up outcomes, or procedure related complications between the groups.ConclusionsEndosaccular coil embolization is safe and feasible for elderly patients with asymptomatic UIAs. Old age itself should not be a contraindication.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25034903</pmid><doi>10.1136/neurintsurg-2014-011305</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Age Factors
Aged
Aged, 80 and over
Aneurysms
Asymptomatic Diseases - therapy
Clinical outcomes
Embolization, Therapeutic - methods
Female
Hemorrhagic Stroke
Humans
Intracranial Aneurysm - therapy
Male
Medical imaging
Morbidity
Mortality
Thromboembolism
Treatment Outcome
title Treatment results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms in elderly patients
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