Age-Related Complications following Endovascular Treatment of Unruptured Intracranial Aneurysms

被引:30
作者
Khosla, A. [2 ]
Brinjikji, W. [2 ]
Cloft, H. [1 ]
Lanzino, G. [1 ]
Kallmes, D. F. [1 ]
机构
[1] Mayo Clin, Dept Radiol, Rochester, MN 55905 USA
[2] Mayo Clin, Mayo Med Sch, Rochester, MN 55905 USA
关键词
CEREBRAL ANEURYSMS; SUBARACHNOID HEMORRHAGE; SURGICAL-TREATMENT; COIL EMBOLIZATION; ELDERLY-PATIENTS; TRIAL; OLDER;
D O I
10.3174/ajnr.A2881
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: The factors that led us to do the research for this paper was a desire to see if elderly patients did as well as non-elderly patients during endovascular intracranial aneurysm treatment. By doing this research, we could better stratify the most appropriate treatment for each patient with an aneurysm. The purpose of this study was to determine whether the incidence of procedural complications was greater in the elderly, defined as patients older than 65 years of age, compared with nonelderly patients undergoing elective endovascular treatment for intracranial aneurysms. MATERIALS AND METHODS: A retrospective review was performed in patients undergoing elective endovascular treatment of intracranial aneurysms between 2000 and 2010 at 1 institution. "Minor complications" were defined as those resulting in minimal or no loss of function that resolved before dismissal; "major complications" were complications that resulted in loss of function or complications that required a subsequent invasive therapy. Major complications were further stratified into those with and without neurologic disability, defined as an mRS score of >3. T tests and x(2) analyses were used to compare groups. RESULTS: Three hundred fifty-five patients underwent 394 endovascular procedures treating 75 aneurysm recurrences and 319 untreated aneurysms. One hundred eight (30%) were elderly. There was no significant difference in the rate of complications in the elderly compared with the nonelderly (33% versus 26%, respectively; P = .18). Major complications were significantly more prevalent in the elderly than in the nonelderly (17% versus 7.4%, respectively, P = .004). Major complications with neurologic disability were also significantly more prevalent in the elderly compared with the nonelderly (8.2% versus 1.8%, respectively, P = .004). CONCLUSIONS: Major functional complications were markedly more common in the elderly compared with the nonelderly.
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收藏
页码:953 / 957
页数:5
相关论文
共 26 条
[1]   Age-dependent differences in short-term outcome after surgical or endovascular treatment of unruptured intracranial aneurysms in the United States, 1996-2000 [J].
Barker, FG ;
Amin-Hanjani, S ;
Butler, WE ;
Hoh, BL ;
Rabinov, JD ;
Pryor, JC ;
Ogilvy, CS ;
Carter, BS .
NEUROSURGERY, 2004, 54 (01) :18-28
[2]   RECOVERY OF MOTOR FUNCTION AFTER STROKE [J].
BONITA, R ;
BEAGLEHOLE, R .
STROKE, 1988, 19 (12) :1497-1500
[3]   Effect of Age on Outcomes of Treatment of Unruptured Cerebral Aneurysms A Study of the National Inpatient Sample 2001-2008 [J].
Brinjikji, Waleed ;
Rabinstein, Alejandro A. ;
Lanzino, Giuseppe ;
Kallmes, David F. ;
Cloft, Harry J. .
STROKE, 2011, 42 (05) :1320-1324
[4]   Endovascular Treatment of Very Small (3 mm or Smaller) Intracranial Aneurysms Report of a Consecutive Series and a Meta-Analysis [J].
Brinjikji, Waleed ;
Lanzino, Giuseppe ;
Cloft, Harry J. ;
Rabinstein, Alejandro ;
Kallmes, David F. .
STROKE, 2010, 41 (01) :116-121
[5]   Endovascular treatment of intracranial aneurysms in the elderly: Single-center experience in 63 consecutive patients [J].
Cai, YL ;
Spelle, L ;
Wang, H ;
Piotin, M ;
Mounayer, C ;
Vanzin, JR ;
Moret, J .
NEUROSURGERY, 2005, 57 (06) :1096-1102
[6]  
Chaer RA, J VASC SURG, V52, P574
[7]   Cerebral reserve is decreased in elderly patients with carotid stenosis [J].
Chaer, Rabih A. ;
Shen, James ;
Cho, Jae S. ;
Abu Hamad, Ghassan ;
Makaroun, Michel S. .
JOURNAL OF VASCULAR SURGERY, 2010, 52 (03) :569-575
[8]   Thromboembolic events after coil embolization of cerebral aneurysms: Prospective study with diffusion-weighted magnetic resonance imaging follw-up [J].
Chung, Seok Won ;
Balk, Seung Kug ;
Kim, Yongsun ;
Park, Jaechan .
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, 2008, 43 (06) :275-280
[9]   Endovascular treatment of intracranial aneurysms in patients 65 years or older:: Clinical outcomes [J].
Gizewski, E. R. ;
Goericke, S. ;
Wolf, A. ;
Schoch, B. ;
Stolke, D. ;
Forsting, M. ;
Wanke, I. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2008, 29 (08) :1575-1580
[10]   Endovascular Coiling of Intracranial Aneurysms in Elderly Patients: Report of 205 Treated Aneurysms [J].
Gonzalez, Nestor R. ;
Dusick, Joshua R. ;
Duckwiler, Gary ;
Tateshima, Satoshi ;
Jahan, Reza ;
Martin, Neil A. ;
Vinuela, Fernando .
NEUROSURGERY, 2010, 66 (04) :714-721