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Outcomes of surgical versus endovascular repair of unruptured brain aneurysms in individuals aged ≥75 years
Author(s) -
Inamasu Joji,
Tanaka Teppei,
Sadato Akiyo,
Hayakawa Motoharu,
Adachi Kazuhide,
Hayashi Takuro,
Kato Yoko,
Hirose Yuichi
Publication year - 2014
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12181
Subject(s) - medicine , modified rankin scale , adverse effect , surgery , intervention (counseling) , activities of daily living , endovascular treatment , retrospective cohort study , mortality rate , single center , aneurysm , life expectancy , physical therapy , nursing , population , ischemic stroke , ischemia , environmental health
Aim Therapeutic intervention to repair unruptured aneurysms ( UA ) has not been strongly recommended for the elderly, because of their limited life expectancy and low annual bleeding rate. However, physically and mentally healthy older adults with seemingly high risk of aneurysmal bleeding might benefit from having their UA repaired. Methods A single‐center retrospective study was carried out. Among 1078 patients admitted for treatment of UA between 2007 and 2011, the number of patients aged ≥75 years who underwent surgical and endovascular repair of UA was 30 and 31, respectively. The operative and mid‐term outcomes were compared between the two groups. For evaluation of the operative outcomes, frequency and types of adverse events that occurred within 30 days of intervention (operative morbidity) were described. For assessment of the mid‐term outcomes, activities of daily living ( ADL ) at 24 months after intervention were evaluated with the modified R ankin S cale (m RS ). Results The operative morbidity rate was 6.7% in the open surgery group and 6.5% in the endovascular surgery group, and they did not differ significantly. The frequency of patients with mRS 0–2 at 24 months after intervention was 85.7% in the open surgery group and 82.8% in the endovascular surgery group, and they did not differ significantly. The adverse event rate of patients with middle cerebral artery aneurysms treated endovascularly was high (80%). Conclusions The outcomes of individuals aged ≥75 years who underwent repair of UA were generally favorable in either treatment group, with more than 80% living an independent life at 24 months after intervention. Geriatr Gerontol Int 2014; 14: 858–863.