Treated unruptured cerebral aneurysm in elderly patients: a single center study

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2023-12-14 DOI:10.1016/j.neuchi.2023.101522

Thomas Metayer , Raphael Blanc , Stanislas Smajda , Jean Philippe Desilles , Hocine Redjem , Simon Escalard , Mikael Mazighi , Adnan Al Tayeb , Erwan Robichon , Amira Al Raaisi , William Boisseau , Francois Delvoye , Michel Piotin

{"title":"Treated unruptured cerebral aneurysm in elderly patients: a single center study","authors":"Thomas Metayer , Raphael Blanc , Stanislas Smajda , Jean Philippe Desilles , Hocine Redjem , Simon Escalard , Mikael Mazighi , Adnan Al Tayeb , Erwan Robichon , Amira Al Raaisi , William Boisseau , Francois Delvoye , Michel Piotin","doi":"10.1016/j.neuchi.2023.101522","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The increase in life expectancy raises the question of the treatment of unruptured intracranial aneurysms in extremely old patients (>80 years). We present results in terms of occlusion and complications in both symptomatic and asymptomatic aneurysm.</p></div><div><h3>Methods</h3><p>All patients aged >80 years admitted to the Foundation Adolphe de Rothschild between January 1, 2005 and March, 2023 were included. Aneurysms were grouped as compressive and non-compressive. Procedural complications were grouped as symptomatic (i.e., leading to any temporary or permanent neurological deficit) and severe (defined by modified Rankin Scale (mRS) ≥3 at follow-up).</p></div><div><h3>Results</h3><p>Forty-two aneurysms were treated in the study period. Coiling (with or without remodeling) was the treatment of choice in 30 patients. Eighteen patients had compressive aneurysm. Six complications occurred (14.2%), all ischemic. The majority of complications occurred in symptomatic aneurysms, in 4 patients (66.6%). One of the patients treated by flow-diverter had severe complications (mRs ≥3) with hemiplegia.</p></div><div><h3>Conclusion</h3><p>In extremely specific cases, treatment of unruptured aneurysm in people older than 80 years may be considered. Compressive aneurysm is associated with a high risk of complications. Treatments can be endovascular. Further prospective studies are required to confirm this hypothesis.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 1","pages":"Article 101522"},"PeriodicalIF":1.5000,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurochirurgie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0028377023001200","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

The increase in life expectancy raises the question of the treatment of unruptured intracranial aneurysms in extremely old patients (>80 years). We present results in terms of occlusion and complications in both symptomatic and asymptomatic aneurysm.

Methods

All patients aged >80 years admitted to the Foundation Adolphe de Rothschild between January 1, 2005 and March, 2023 were included. Aneurysms were grouped as compressive and non-compressive. Procedural complications were grouped as symptomatic (i.e., leading to any temporary or permanent neurological deficit) and severe (defined by modified Rankin Scale (mRS) ≥3 at follow-up).

Results

Forty-two aneurysms were treated in the study period. Coiling (with or without remodeling) was the treatment of choice in 30 patients. Eighteen patients had compressive aneurysm. Six complications occurred (14.2%), all ischemic. The majority of complications occurred in symptomatic aneurysms, in 4 patients (66.6%). One of the patients treated by flow-diverter had severe complications (mRs ≥3) with hemiplegia.

Conclusion

In extremely specific cases, treatment of unruptured aneurysm in people older than 80 years may be considered. Compressive aneurysm is associated with a high risk of complications. Treatments can be endovascular. Further prospective studies are required to confirm this hypothesis.

查看原文本刊更多论文

老年未破裂脑动脉瘤治疗：一项单中心研究

预期寿命的增加提出了对高龄患者(80岁)未破裂颅内动脉瘤治疗的问题。我们提出的结果，在闭塞和并发症的症状和无症状的动脉瘤。方法选取2005年1月1日至2023年3月在Adolphe de Rothschild基金会就诊的80岁患者。动脉瘤分为压缩性和非压缩性。手术并发症分为症状性(即导致任何暂时性或永久性神经功能缺损)和重度(随访时以改良Rankin量表(mRS)≥3定义)。结果本组共治疗42例动脉瘤。30例患者选择盘绕(伴或不伴重塑)作为治疗方法。18例患者有压缩性动脉瘤。并发症6例(14.2%)，均为缺血性并发症。并发症主要发生在有症状的动脉瘤，4例(66.6%)。1例经分流治疗的患者出现严重并发症(mRs≥3)伴偏瘫。结论在特殊情况下，可考虑对80岁以上人群的未破裂动脉瘤进行治疗。压缩性动脉瘤与并发症的高风险相关。治疗可以在血管内进行。需要进一步的前瞻性研究来证实这一假设。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.