title: Treatment results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms in elderly patients.
abstract: OBJECTIVE
  We report the results of endosaccular coil embolization of asymptomatic unruptured intracranial aneurysms (UIAs) in elderly patients (≥65 years).
  
  
  METHODS
  There were 375 elderly patients with 400 asymptomatic UIAs. Patients were divided into two groups: group A included patients aged 65-74 years and group B patients aged ≥75 years.
  
  
  RESULTS
  Endovascular procedures were completed in 97.8% of patients. Immediate anatomical outcomes showed complete occlusion in 53.7%, residual neck in 18.9%, and residual aneurysm in 27.4%. Anatomical follow-ups (mean 36.3±28.1 months) were unchanged in 55.7%, improved in 22.6%, minor recurrence in 11.5%, and major recurrence in 10.2%. Procedure related complications occurred in 31 patients (8.3%). 15 patients had ischemic and 10 hemorrhagic complications. Retreatments were performed in 16 patients (4.3%). Among 366 patients technically completed, 363 (99.2%) showed a favorable clinical outcome (modified Rankin Scale (mRS) score <1) at 30 days. The remaining three patients showed a worsening of mRS >0 at 30 days. The latest clinical follow-up outcomes showed: mRS score 0 in 362 patients; mRS score 1 in one; mRS score 3 in one; mRS score 4 in one; and mRS score 5 in one patient. Permanent morbidity and mortality rates were 1.1% and 0%, respectively. There were no statistically significant differences in gender, comorbidities, aneurysm size, neck width, dome-to-neck ratio, immediate anatomical outcomes, anatomical follow-up outcomes, or procedure related complications between the groups.
  
  
  CONCLUSIONS
  Endosaccular coil embolization is safe and feasible for elderly patients with asymptomatic UIAs. Old age itself should not be a contraindication.
authors.affiliation: Department of Neuroendovascular Therapy, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Oishi
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Juntendo Urayasu Hospital, Tokyo, Japan.
authors.forename: Senshu
authors.initials: S
authors.lastname: Nonaka
authors.affiliation: Department of Neurosurgery, Juntendo Nerima Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Neurosurgery, Tama-Nanbu Chiiki Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mitsuhashi
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Arai
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases / Q000628:therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D016896:Treatment Outcome
keywords: Aneurysm; Intervention