Endovascular coil embolization for cerebral aneurysms in the elderly in an aging society

Abstract

Objective: An aging or aged society is and has been a reality in many developed countries. Additionally, the incidence of subarachnoid hemorrhage (SAH) in elderly patients has been estimated to be increasing. However, the outcomes of SAH treatment by clipping or coiling in elderly patients are poor. Therefore, preventative surgery for elderly patients with unruptured cerebral aneurysm is becoming increasingly important. The aim of this study was to analyze the safety and efficacy of endovascular coil embolization for elderly patients with cerebral aneurysm. Methods: A total of 252 patients (264 aneurysms) who underwent endovascular coil embolization for cerebral aneurysms between April 2012 and August 2018 at our institution were included. This study is retrospective observational study, and we retrospectively investigated treatment outcomes and perioperative complications in nonelderly patients and elderly patients with ruptured or unruptured cerebral aneurysms, who underwent endovascular coil embolization. We defined patients aged < 65 years as nonelderly and aged > 65 years as elderly. Results: Among the elderly patients with unruptured aneurysms, there was a higher proportion of cases with residual aneurysm as an embolic state immediately after operation and high-intensity spots in magnetic resonance imaging–diffusion-weighted imaging on the day after the operation as compared with the nonelderly. However, there were no differences between nonelderly and elderly patients with regard to the number of cases with modified Rankin Scale 3–5 and 6 at discharge, the number of re-operation, and postoperative rupture. Conclusions: In this study, endovascular coil embolization was determined to be a safe and efficacious procedure for elderly patients with unruptured cerebral aneurysm.