Surgical Results of Unruptured Intracranial Aneurysms in the Elderly : Single Center Experience in the Past Ten Years. |
Young Jin Jung, Jae Sung Ahn, Eun Suk Park, Do Hoon Kwon, Byung Duk Kwun, Chang Jin Kim |
Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. jsahn@amc.seoul.kr |
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ABSTRACT |
OBJECTIVE As medical advances have increased life expectancy, it has become imperative to develop specific treatment strategies for intracranial aneurysms in the elderly. We therefore analyzed the clinical characteristics and outcomes of the treatment of unruptured intracranial aneurysms in patients older than 70 years. METHODS We retrospectively reviewed the medical records and results of neuroimaging modalities on 54 aneurysms of 48 consecutive patients with unruptured intracranial aneurysms.
(mean+/-SD age, 72.11+/-1.96 years; range, 70-78 years) who underwent surgical clipping over 10 years (May 1999 to June 2010). RESULTS Of the 54 aneurysms, 22 were located in the internal carotid artery, 19 in the middle cerebral artery, 12 in the anterior cerebral artery, and 1 in the superior cerebellar artery. Six patients had multiple aneurysms.
Aneurysm size ranged from 3 mm to 17 mm (mean+/-SD, 6.82+/-3.07 mm). Fifty of the 54 aneurysms (92.6%) were completely clipped. Three-month outcomes were excellent in 50 (92.6%) aneurysms and good and poor in 2 each (3.7%), with 1 death (2.0%). Procedure-related complications occurred in 7 aneurysms (13.0%), with 2 (3.7%) resulting in permanent neurological deficits, including death. No postoperative subarachnoid hemorrhage occurred during follow-up. The cumulative rates of stroke- or death-free survival at 5 and 10 years were 100% and 78%, respectively. CONCLUSION Surgical clipping of unruptured intracranial aneurysms in elderly group could get it as a favorable outcome in well selected cases. |
Key Words:
Unruptured intracranial aneurysm; Surgical clipping; Elderly; Outcome |
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