title: Endovascular treatment of cerebral aneurysms in elderly patients.
abstract: We report our experience in the endovascular treatment with detachable platinum coils of ruptured or symptomatic unruptured cerebral aneurysms in 61 patients aged 70-82 years. Complete occlusion was achieved in 38, subtotal in 17 and partial in one. The treatment failed in five patients. Clinical follow-up was performed in all patients for 8 months to 8 years. No bleeding occurred during the follow-up period. Outcome was favourable in 63% of the patients. When we compared the outcome of elderly patients with those of younger age endovascularly treated in the same period of time, we found a significantly higher frequency of poorer outcome in the elderly group (chi(2) = 9.084; P = 0.011). The frequency of favourable outcome in the elderly was significantly lower than in the younger group for H-H IV-V (chi(2) = 9.299; P = 0.010). The most important factor influencing the outcome was not age itself, but primary clinical condition on admission. The therapy of symptomatic aneurysms in elderly patients should not be purely conservative--a direct approach of the aneurysm should be considered. Endovascular treatment whenever possible seems to be a good alternative to surgery.
authors.affiliation: Department of Neuroradiology, University of Turin, Italy. gianniboris.bradac@unito.it
authors.forename: G B
authors.initials: GB
authors.lastname: Bradac
authors.forename: M
authors.initials: M
authors.lastname: Bergui
authors.forename: M
authors.initials: M
authors.lastname: Fontanella
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome