title: Endovascular treatment for elderly patients with ruptured aneurysm.
abstract: We report our results of endovascular treatment for elderly patients with ruptured aneurysm and discuss the indication for treatment. One hundred and thirty four consecutive patients with ruptured aneurysm treated in our institute during the last 4 years were retrospectively evaluated. Fifty eight patients were included in group A (over 70 years old), and 76 patients in group B (under 69 years old). In both groups, the outcome was strongly related to the preoperative Hunt & Kosnik grade. However, significant risk factors (i.e. pneumonia, rupture of extracranial aneurysm) which make prognosis poor were more common in group A. Group A showed poor outcome in grade III patients, although there were no outcome differences between the two groups in patients of other grades. Endovascular treatment for elderly patients with ruptured aneurysms seemed to be useful. Their outcome was strongly related to their preoperative condition. General risk factors should be evaluated before treatment, especially in elderly patients. Patients with low Hunt & Kosnik grade seem to be most suitable for endovascular treatment. On the other hand, outcome of patients with poor preoperative grade was worse despite the less invasive nature of endovascular treatment. An improvement of outcome in grade III patients is desirable.
authors.affiliation: Department of Neurological Surgery, Okayama University Medical School, Okayama, Japan. ksugiu@md.okayama-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Sugiu
authors.forename: K
authors.initials: K
authors.lastname: Tokunaga
authors.forename: K
authors.initials: K
authors.lastname: Watanabe
authors.forename: W
authors.initials: W
authors.lastname: Sasahara
authors.forename: M
authors.initials: M
authors.lastname: Tagawa
authors.forename: N
authors.initials: N
authors.lastname: Tamesa
authors.forename: S
authors.initials: S
authors.lastname: Ono
authors.forename: K
authors.initials: K
authors.lastname: Onoda
authors.forename: I
authors.initials: I
authors.lastname: Date
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000453:epidemiology* / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000706:statistics & numerical data*