Impact of age on cerebral aneurysm occlusion after flow diversion
•PED use is feasible and safe across different patient age groups.•Older patients required longer time period to achieve aneurysm occlusion.•Further studies on age-related factors relating to aneurysm occlusion are needed. The purpose of this study was to evaluate safety and efficacy of the pipeline...
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| Veröffentlicht in: | Journal of clinical neuroscience 2019-07, Vol.65, p.23-27 |
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| container_title | Journal of clinical neuroscience |
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| creator | Kühn, Anna Luisa Kan, Peter Henninger, Nils Srinivasan, Visish de Macedo Rodrigues, Katyucia Wakhloo, Ajay K. Gounis, Matthew J. Puri, Ajit S. |
| description | •PED use is feasible and safe across different patient age groups.•Older patients required longer time period to achieve aneurysm occlusion.•Further studies on age-related factors relating to aneurysm occlusion are needed.
The purpose of this study was to evaluate safety and efficacy of the pipeline embolization device (PED) in different patient age groups with unruptured intracranial aneurysms (UIA).
All patients with UIA treated with the PED between 2011 and 2017 were included. Based on their age, patients were trichotomized to: young (≤45 years), middle-aged (46 to |
| doi_str_mv | 10.1016/j.jocn.2019.04.024 |
| format | Article |
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The purpose of this study was to evaluate safety and efficacy of the pipeline embolization device (PED) in different patient age groups with unruptured intracranial aneurysms (UIA).
All patients with UIA treated with the PED between 2011 and 2017 were included. Based on their age, patients were trichotomized to: young (≤45 years), middle-aged (46 to <65 years) and older (≥65 years) groups. Patient’s vascular risk factors, presenting symptoms and mRS on admission were collected. Follow-up imaging was evaluated for presence/absence of aneurysm occlusion. Clinical outcome at discharge, 3–9 months and 12–18 months was also documented when available.
A total of 260 patients harboring 307 aneurysms (young = 57, middle-age = 144 and older age group = 64). Most aneurysms were located in the anterior circulation (94.8%). Overall morbidity and mortality was 2.3% each (6/260). At 3–9 months near complete to complete aneurysm occlusion was 82.5% (47/57) in the young age group, 82.6% (100/121) in the middle age, and 70.2% (40/57) in the older age group. At 12–18-month, near complete to complete occlusion was 100% in the young age group (32/32), 91.4% (64/70) in the middle age, and 78.4% (29/37) in the older age group. After adjustment for potential confounders, older age patients less frequently achieved near complete to complete occlusion by 3 years than younger subjects (p = 0.009, HR 1.34 95%, CI 1.08–1.66).
Our results indicate feasibility and safety of PED across different age groups. Further study is required to determine age-related factors relating to aneurysm occlusion after PED to improve outcome and patient counseling.</description><identifier>ISSN: 0967-5868</identifier><identifier>EISSN: 1532-2653</identifier><identifier>DOI: 10.1016/j.jocn.2019.04.024</identifier><identifier>PMID: 31072739</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Adult ; Age ; Age Factors ; Aged ; Blood Vessel Prosthesis ; Embolization, Therapeutic - instrumentation ; Embolization, Therapeutic - methods ; Female ; Flow diverter ; Humans ; Intracranial aneurysm ; Intracranial Aneurysm - therapy ; Male ; Middle Aged ; Occlusion ; Pipeline embolization device ; Retrospective Studies ; Risk Factors ; Stent ; Treatment Outcome ; Unruptured</subject><ispartof>Journal of clinical neuroscience, 2019-07, Vol.65, p.23-27</ispartof><rights>2019 Elsevier Ltd</rights><rights>Copyright © 2019 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-fe5269018b70822fd755fc57872638a995a17725c84c877dc9dc64f908f94b0e3</citedby><cites>FETCH-LOGICAL-c455t-fe5269018b70822fd755fc57872638a995a17725c84c877dc9dc64f908f94b0e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0967586819303030$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31072739$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kühn, Anna Luisa</creatorcontrib><creatorcontrib>Kan, Peter</creatorcontrib><creatorcontrib>Henninger, Nils</creatorcontrib><creatorcontrib>Srinivasan, Visish</creatorcontrib><creatorcontrib>de Macedo Rodrigues, Katyucia</creatorcontrib><creatorcontrib>Wakhloo, Ajay K.</creatorcontrib><creatorcontrib>Gounis, Matthew J.</creatorcontrib><creatorcontrib>Puri, Ajit S.</creatorcontrib><title>Impact of age on cerebral aneurysm occlusion after flow diversion</title><title>Journal of clinical neuroscience</title><addtitle>J Clin Neurosci</addtitle><description>•PED use is feasible and safe across different patient age groups.•Older patients required longer time period to achieve aneurysm occlusion.•Further studies on age-related factors relating to aneurysm occlusion are needed.
The purpose of this study was to evaluate safety and efficacy of the pipeline embolization device (PED) in different patient age groups with unruptured intracranial aneurysms (UIA).
All patients with UIA treated with the PED between 2011 and 2017 were included. Based on their age, patients were trichotomized to: young (≤45 years), middle-aged (46 to <65 years) and older (≥65 years) groups. Patient’s vascular risk factors, presenting symptoms and mRS on admission were collected. Follow-up imaging was evaluated for presence/absence of aneurysm occlusion. Clinical outcome at discharge, 3–9 months and 12–18 months was also documented when available.
A total of 260 patients harboring 307 aneurysms (young = 57, middle-age = 144 and older age group = 64). Most aneurysms were located in the anterior circulation (94.8%). Overall morbidity and mortality was 2.3% each (6/260). At 3–9 months near complete to complete aneurysm occlusion was 82.5% (47/57) in the young age group, 82.6% (100/121) in the middle age, and 70.2% (40/57) in the older age group. At 12–18-month, near complete to complete occlusion was 100% in the young age group (32/32), 91.4% (64/70) in the middle age, and 78.4% (29/37) in the older age group. After adjustment for potential confounders, older age patients less frequently achieved near complete to complete occlusion by 3 years than younger subjects (p = 0.009, HR 1.34 95%, CI 1.08–1.66).
Our results indicate feasibility and safety of PED across different age groups. Further study is required to determine age-related factors relating to aneurysm occlusion after PED to improve outcome and patient counseling.</description><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Blood Vessel Prosthesis</subject><subject>Embolization, Therapeutic - instrumentation</subject><subject>Embolization, Therapeutic - methods</subject><subject>Female</subject><subject>Flow diverter</subject><subject>Humans</subject><subject>Intracranial aneurysm</subject><subject>Intracranial Aneurysm - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Occlusion</subject><subject>Pipeline embolization device</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stent</subject><subject>Treatment Outcome</subject><subject>Unruptured</subject><issn>0967-5868</issn><issn>1532-2653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9v1DAQxS1ERZfCF-CAcuSSMHb8V0JIVdVCpUq9wNnyOuPiVRIvdrKo3x6vtlRw4TTSzJs3b36EvKPQUaDy467bJT93DKjpgHfA-AuyoaJnLZOif0k2YKRqhZb6nLwuZQcAhvfwipz3FBRTvdmQy9tp7_zSpNC4B2zS3HjMuM1ubNyMa34sU5O8H9cS68yFBXMTxvSrGeIB87H5hpwFNxZ8-1QvyPeb629XX9u7-y-3V5d3redCLG1AwaQBqrcKNGNhUEIEL5RWTPbaGSMcVYoJr7nXSg3eDF7yYEAHw7eA_QX5fPLdr9sJB4_zUlPafY6Ty482uWj_nczxh31IBysNp1zpavDhySCnnyuWxU6xeBzH-mhai2Wsp4ZSKVmVspPU51RKxvB8hoI9src7e2Rvj-wtcFvZ16X3fwd8XvkDuwo-nQRYMR0iZlt8xNnjEDP6xQ4p_s__NzuClcU</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Kühn, Anna Luisa</creator><creator>Kan, Peter</creator><creator>Henninger, Nils</creator><creator>Srinivasan, Visish</creator><creator>de Macedo Rodrigues, Katyucia</creator><creator>Wakhloo, Ajay K.</creator><creator>Gounis, Matthew J.</creator><creator>Puri, Ajit S.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190701</creationdate><title>Impact of age on cerebral aneurysm occlusion after flow diversion</title><author>Kühn, Anna Luisa ; Kan, Peter ; Henninger, Nils ; Srinivasan, Visish ; de Macedo Rodrigues, Katyucia ; Wakhloo, Ajay K. ; Gounis, Matthew J. ; Puri, Ajit S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-fe5269018b70822fd755fc57872638a995a17725c84c877dc9dc64f908f94b0e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Blood Vessel Prosthesis</topic><topic>Embolization, Therapeutic - instrumentation</topic><topic>Embolization, Therapeutic - methods</topic><topic>Female</topic><topic>Flow diverter</topic><topic>Humans</topic><topic>Intracranial aneurysm</topic><topic>Intracranial Aneurysm - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Occlusion</topic><topic>Pipeline embolization device</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stent</topic><topic>Treatment Outcome</topic><topic>Unruptured</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kühn, Anna Luisa</creatorcontrib><creatorcontrib>Kan, Peter</creatorcontrib><creatorcontrib>Henninger, Nils</creatorcontrib><creatorcontrib>Srinivasan, Visish</creatorcontrib><creatorcontrib>de Macedo Rodrigues, Katyucia</creatorcontrib><creatorcontrib>Wakhloo, Ajay K.</creatorcontrib><creatorcontrib>Gounis, Matthew J.</creatorcontrib><creatorcontrib>Puri, Ajit S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical neuroscience</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kühn, Anna Luisa</au><au>Kan, Peter</au><au>Henninger, Nils</au><au>Srinivasan, Visish</au><au>de Macedo Rodrigues, Katyucia</au><au>Wakhloo, Ajay K.</au><au>Gounis, Matthew J.</au><au>Puri, Ajit S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of age on cerebral aneurysm occlusion after flow diversion</atitle><jtitle>Journal of clinical neuroscience</jtitle><addtitle>J Clin Neurosci</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>65</volume><spage>23</spage><epage>27</epage><pages>23-27</pages><issn>0967-5868</issn><eissn>1532-2653</eissn><abstract>•PED use is feasible and safe across different patient age groups.•Older patients required longer time period to achieve aneurysm occlusion.•Further studies on age-related factors relating to aneurysm occlusion are needed.
The purpose of this study was to evaluate safety and efficacy of the pipeline embolization device (PED) in different patient age groups with unruptured intracranial aneurysms (UIA).
All patients with UIA treated with the PED between 2011 and 2017 were included. Based on their age, patients were trichotomized to: young (≤45 years), middle-aged (46 to <65 years) and older (≥65 years) groups. Patient’s vascular risk factors, presenting symptoms and mRS on admission were collected. Follow-up imaging was evaluated for presence/absence of aneurysm occlusion. Clinical outcome at discharge, 3–9 months and 12–18 months was also documented when available.
A total of 260 patients harboring 307 aneurysms (young = 57, middle-age = 144 and older age group = 64). Most aneurysms were located in the anterior circulation (94.8%). Overall morbidity and mortality was 2.3% each (6/260). At 3–9 months near complete to complete aneurysm occlusion was 82.5% (47/57) in the young age group, 82.6% (100/121) in the middle age, and 70.2% (40/57) in the older age group. At 12–18-month, near complete to complete occlusion was 100% in the young age group (32/32), 91.4% (64/70) in the middle age, and 78.4% (29/37) in the older age group. After adjustment for potential confounders, older age patients less frequently achieved near complete to complete occlusion by 3 years than younger subjects (p = 0.009, HR 1.34 95%, CI 1.08–1.66).
Our results indicate feasibility and safety of PED across different age groups. Further study is required to determine age-related factors relating to aneurysm occlusion after PED to improve outcome and patient counseling.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>31072739</pmid><doi>10.1016/j.jocn.2019.04.024</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical neuroscience, 2019-07, Vol.65, p.23-27 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Age Age Factors Aged Blood Vessel Prosthesis Embolization, Therapeutic - instrumentation Embolization, Therapeutic - methods Female Flow diverter Humans Intracranial aneurysm Intracranial Aneurysm - therapy Male Middle Aged Occlusion Pipeline embolization device Retrospective Studies Risk Factors Stent Treatment Outcome Unruptured |
| title | Impact of age on cerebral aneurysm occlusion after flow diversion |
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