Park Dong Sun, Roh Hong Gee, Chun Young Il, Jeon Yoo Sung
Department of Neurosurgery, Hanyang University Changwon Hanmaeum Hospital, Changwon 51139, Republic of Korea.
Department of Radiology, Konkuk University Medical Center, Seoul 05030, Republic of Korea.
J Clin Med. 2024 Aug 13;13(16):4764. doi: 10.3390/jcm13164764.
Ruptured and unruptured aneurysms are less common in younger individuals compared to older patients. Endovascular treatment has gained popularity over surgical options in the general population, but surgery remains the primary treatment for younger patients due to concerns about higher recurrence rates with endovascular procedures. This study compared the immediate and long-term outcomes of endovascular treatment in patients under 40 years with those aged 41-60. The study included 239 patients who underwent endovascular treatment for intracranial aneurysms, divided into two age groups: under 40 and 41-60 years. The rates of immediate radiologic outcomes, complications, and recurrence were assessed. The results showed successful aneurysm obliteration rates of 70.1% in the younger group and 64.0% in the older group. The complication rates were 1.5% in the younger group and 3.5% in the older group, with the older group experiencing more procedure-related complications, though this difference was not statistically significant. Long-term follow-up revealed recurrence rates of 23.2% in the younger group and 18.2% in the older group, with no significant difference. The study suggests that endovascular treatment is as effective and safe for patients under 40 years. Therefore, it may be considered an acceptable first-line treatment for younger patients, aligning its use with that in older populations.
与老年患者相比，破裂和未破裂的动脉瘤在年轻个体中不太常见。在普通人群中，血管内治疗比手术选择更受欢迎，但由于担心血管内手术的复发率较高，手术仍然是年轻患者的主要治疗方法。本研究比较了40岁以下患者与41 - 60岁患者血管内治疗的近期和长期结果。该研究纳入了239例接受颅内动脉瘤血管内治疗的患者，分为两个年龄组：40岁以下和41 - 60岁。评估了近期影像学结果、并发症和复发率。结果显示，较年轻组的动脉瘤成功闭塞率为70.1%，较年长组为64.0%。较年轻组的并发症发生率为1.5%，较年长组为3.5%，较年长组经历了更多与手术相关的并发症，尽管这种差异无统计学意义。长期随访显示，较年轻组的复发率为23.2%，较年长组为18.2%，无显著差异。该研究表明，血管内治疗对40岁以下患者同样有效且安全。因此，对于年轻患者，它可被视为一种可接受的一线治疗方法，其使用与老年人群一致。
