颅内未破裂动脉瘤血管内治疗后的年龄相关并发症。
Age-related complications following endovascular treatment of unruptured intracranial aneurysms.
机构信息
Mayo Medical School, Mayo Clinic, Rochester, MN 55905, USA.
出版信息
AJNR Am J Neuroradiol. 2012 May;33(5):953-7. doi: 10.3174/ajnr.A2881. Epub 2012 Jan 12.
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 χ(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.
背景与目的
我们开展这项研究的原因是，希望了解在血管内颅内动脉瘤治疗中，老年患者的表现是否与非老年患者一样好。通过这项研究，我们可以更好地为每位动脉瘤患者分层最合适的治疗方法。本研究旨在确定与非老年患者相比，年龄在 65 岁以上的老年患者在接受择期血管内治疗颅内动脉瘤时，手术并发症的发生率是否更高。
材料与方法
在一家机构对 2000 年至 2010 年间接受择期血管内治疗颅内动脉瘤的患者进行了回顾性研究。“轻微并发症”定义为导致功能丧失最小或无丧失且在出院前得到解决的并发症；“严重并发症”是指导致功能丧失或需要进一步侵入性治疗的并发症。将严重并发症进一步分为有和无神经功能障碍的并发症，定义为 mRS 评分>3。使用 t 检验和 χ(2)分析比较组间差异。
结果
355 例患者接受了 394 次血管内治疗，治疗了 75 例动脉瘤复发和 319 例未治疗的动脉瘤。108 例（30%）为老年人。与非老年人相比，老年人的并发症发生率无显著差异（分别为 33%和 26%，P=0.18）。老年人严重并发症的发生率明显高于非老年人（分别为 17%和 7.4%，P=0.004）。老年患者严重并发症伴神经功能障碍的发生率也明显高于非老年患者（分别为 8.2%和 1.8%，P=0.004）。
结论
与非老年人相比，老年人的主要功能并发症明显更为常见。
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