Department of emergency medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
Department of Neurosurgery, Myong-Ji St. Mary's Hospital, 156, Dorimro, Youngdungpo-gu, Seoul, 07417, Republic of Korea.
Acta Neurochir (Wien). 2023 Nov;165(11):3361-3369. doi: 10.1007/s00701-023-05793-2. Epub 2023 Sep 20.
This single center study aims to compare the treatment outcomes and procedure-related complications of coil embolization in elderly patients (60-79 years) and very elderly patients (aged 80 years or older) with cerebral aneurysms.
Data was collected from 504 elderly patients aged 60 years or older who underwent coil embolization for intracranial aneurysms from 2018 to 2021. The study evaluated patient-related and anatomical factors and assessed various outcomes, comparing results between groups using statistical analysis and propensity score matching.
A total of 503 cerebral aneurysms were analyzed from individuals aged 60-79 years (n = 472) and those aged 80 years or older (n = 31). The majority of the aneurysms were unruptured with an average size of 3.5 mm in height and 3.4 mm in width. The patients were compared using 1:1 propensity score matching, and no significant differences were found in factors other than age and aortic elongation. Logistic analysis revealed that being over 80 years old and having a severe aortic arch elongation were identified as risk factors for procedure-related events in both total and unruptured cases.
The study compared coil embolization treatment for cerebral aneurysms in patients aged 60-79 and over 80, finding no significant difference in treatment outcomes except for procedure-related events. Procedure-related events were associated with severe aortic arch elongation and being over 80 years old. Coil embolization can be considered safe and effective for patients over 80, but further trials are needed for accurate conclusions.
本单中心研究旨在比较老年(60-79 岁)和非常老年(80 岁及以上)患者颅内动脉瘤采用弹簧圈栓塞治疗的治疗结果和与操作相关的并发症。
收集了 2018 年至 2021 年间 504 例接受颅内动脉瘤弹簧圈栓塞治疗的 60 岁以上老年患者的数据。本研究评估了患者相关和解剖学因素,并评估了各种结果,通过统计分析和倾向评分匹配比较了两组之间的结果。
共分析了年龄在 60-79 岁(n = 472)和 80 岁及以上(n = 31)的患者的 503 个颅内动脉瘤。大多数动脉瘤未破裂,平均高度为 3.5mm,宽度为 3.4mm。使用 1:1 倾向评分匹配对患者进行比较,除年龄和主动脉伸长外,其他因素无显著差异。Logistic 分析显示,80 岁以上和严重主动脉弓伸长是总病例和未破裂病例与操作相关事件的危险因素。
该研究比较了 60-79 岁和 80 岁以上患者的颅内动脉瘤弹簧圈栓塞治疗,除与操作相关的事件外,治疗结果无显著差异。与操作相关的事件与严重的主动脉弓伸长和 80 岁以上有关。对于 80 岁以上的患者,弹簧圈栓塞治疗可以被认为是安全有效的,但需要进一步的试验来得出准确的结论。