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Abstract - Original Article

J Cerebrovasc Endovasc Neurosurg. 2020 22(4): 237-244
The Journal of Cerebrovascular and Endovascular Neurosurgery
Endovascular coil embolization for unruptured intracranial aneurysms in patients over 80 years of age
Eun-Oh Jeong1, Hyeon-Song Koh1,2, Kyung Hwan Kim1, Seung-Won Choi1,2, Seon-Hwan Kim1,2, Jin-Young Youm1,2
1Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea, 2Department of Neurosurgery, School of Medicine, Chungnam National University, Daejeon, Korea

Objective: As the average life span in modern society continues to increase, much interest is focused on high-risk procedures in elderly patients, including major surgical operations. We investigated the results of endovascular coiling of unruptured intracranial aneurysms (UIA) in patients over 80 years of age. Methods: We retrospectively analyzed 39 patients aged over 80 years who underwent coil embolization for UIA between April 2007 and April 2019 at our hospital. Results: Complete occlusion on digital subtraction angiography (DSA) immediately after surgery was performed in 44 (84.6%) of 52 cases of cerebral aneurysms. Four patients (7.7%) had residual aneurysmal necks, and four (7.7%) had contrast flow in the aneurysmal sac. Follow-up magnetic resonance angiography (mean: 8.2 months) was performed in 37 aneurysms in 24 patients. There was evidence of blood flow in the neck in seven cases (18.9%) and aneurysm in two cases (5.4%). Follow-up DSA (mean: 20.5 months) was performed in 14 aneurysms in 11 patients, and 11 aneurysms (78.6%) had complete occlusion, 1 aneurysm (7.1%) had an aneurysmal neck, and 2 aneurysms (14.3%) had contrast filling into the aneurysmal sac. Coil embolization procedure-related complications occurred in 3 patients (7.7%). Cerebral infarction occurred in 1 (2.6%), arterial dissection in 1 (2.6%), and hypoesthesia in 1 (2.6%). Conclusions: Active treatment of UIA in elderly patients over 80 years of age through endovascular coil embolization can be considered.
Key words : Elderly, Endovascular procedures, Intracranial aneurysm, Coil

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