title: Outcomes of surgical versus endovascular repair of unruptured brain aneurysms in individuals aged ≥ 75 years.
abstract: OBJECTIVE
  Therapeutic intervention to repair unruptured aneurysms (UA) has not been strongly recommended for the elderly, because of their limited life expectancy and low annual bleeding rate. However, physically and mentally healthy older adults with seemingly high risk of aneurysmal bleeding might benefit from having their UA repaired.
  
  
  METHODS
  A single-center retrospective study was carried out. Among 1078 patients admitted for treatment of UA between 2007 and 2011, the number of patients aged ≥ 75 years who underwent surgical and endovascular repair of UA was 30 and 31, respectively. The operative and mid-term outcomes were compared between the two groups. For evaluation of the operative outcomes, frequency and types of adverse events that occurred within 30 days of intervention (operative morbidity) were described. For assessment of the mid-term outcomes, activities of daily living (ADL) at 24 months after intervention were evaluated with the modified Rankin Scale (mRS).
  
  
  RESULTS
  The operative morbidity rate was 6.7% in the open surgery group and 6.5% in the endovascular surgery group, and they did not differ significantly. The frequency of patients with mRS 0-2 at 24 months after intervention was 85.7% in the open surgery group and 82.8% in the endovascular surgery group, and they did not differ significantly. The adverse event rate of patients with middle cerebral artery aneurysms treated endovascularly was high (80%).
  
  
  CONCLUSIONS
  The outcomes of individuals aged ≥ 75 years who underwent repair of UA were generally favorable in either treatment group, with more than 80% living an independent life at 24 months after intervention.
authors.affiliation: Department of Neurosurgery, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Inamasu
authors.forename: Teppei
authors.initials: T
authors.lastname: Tanaka
authors.forename: Akiyo
authors.initials: A
authors.lastname: Sadato
authors.forename: Motoharu
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Adachi
authors.forename: Takuro
authors.initials: T
authors.lastname: Hayashi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kato
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hirose
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000503:physiopathology / Q000601:surgery*; D007564:Japan / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: complication; endovascular; outcomes; surgical; unruptured aneurysm