Endovascular Treatment and Microsurgical Treatment of Intracranial Aneurysms in the Elderly / 대한뇌혈관외과학회지

ABSTRACT

BACKGROUND: The prevalence of intracranial aneurysms in the elderly is increasing. However, most treatment strategies for the elderly is controversial and related research in the elderly has been insufficient. METHODS: Eighty-four patients > 65 years of age with intracranial aneurysms who received definitive treatment at our hospital between March 2007 and June 2010 were subjected to this study. Thirty-seven patients who had undergone endovascular treatment (EVT) were categorized into group I, while 47 patients who had undergone microsurgical treatment (MST) were categorized into group II. RESULTS: When the Glasgow Outcome Scale (GOS) score, which was independent to rupture, was evaluated at the time of discharge there was a trend of acquiring much better GOS scores (GOS> or =4) when the Hunt-Hess grade (HHG) is good (HHG< or =2) and the size of the aneurysm is small (<10 mm; p=0.001 [HHG] and p=0.000 [aneurysm size]). In the two groups in which EVT and MST were performed, the average values of the GOS scores by Student's t-test displayed a significant difference (4.54 [EVT] and 4.13 [MST], respectively, p=0.046). However, univariate and multivariate analyses were not statistically significant. CONCLUSION: If the clinical results are similar in the EVT and MST for intracranial aneurysms, then EVT is less invasive with less post-procedural complications would be considered with priority in elderly patients.