title: The significance of retrograde thrombosis following removal of arteriovenous malformations in elderly patients.
abstract: BACKGROUND
  Retrograde thrombosis of former feeding arteries should be considered as a distinct postoperative complication following surgery for arteriovenous malformation (AVM). Regardless of the presence of AVMs, the cerebral arteries undergo atherosclerotic changes with advancing age. In the present study, three cases in elderly patients who developed retrograde thrombosis are reported, and the effect of the patient's age on this complication is discussed.
  
  
  METHODS
  The present study group consisted of 158 patients who underwent AVM resection and postoperative angiographic studies. Five patients were 65 years of age or older (elderly group) at the time of operation, 108 were between 20 and 64 years of age (adult group), and 45 were less than 20 years of age (young group). The incidence of retrograde thrombosis in the elderly group was compared with that of the other two groups.
  
  
  RESULTS
  We found that surgery in the elderly group was accompanied by a significantly higher incidence of retrograde thrombosis (60%) than in the adult group (4%), or the young group (0%).
  
  
  CONCLUSIONS
  The present study suggests that this complication should be considered as a serious possibility following removal of an AVM, especially in elderly patients.
authors.affiliation: Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Miyasaka
authors.forename: A
authors.initials: A
authors.lastname: Kurata
authors.forename: R
authors.initials: R
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Irikura
authors.forename: M
authors.initials: M
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002533:Cerebral Angiography; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D014656:Vascular Surgical Procedures / Q000009:adverse effects*