Endovascular treatment of cerebral aneurysms in elderly patients

We report our experience in the endovascular treatment with detachable platinum coils of ruptured or symptomatic unruptured cerebral aneurysms in 61 patients aged 70–82 years. Complete occlusion was achieved in 38, subtotal in 17 and partial in one. The treatment failed in five patients. Clinical follow-up was performed in all patients for 8 months to 8 years. No bleeding occurred during the follow-up period. Outcome was favourable in 63% of the patients. When we compared the outcome of elderly patients with those of younger age endovascularly treated in the same period of time, we found a significantly higher frequency of poorer outcome in the elderly group (χ²=9.084; P=0.011). The frequency of favourable outcome in the elderly was significantly lower than in the younger group for H–H IV–V (χ²=9.299; P=0.010). The most important factor influencing the outcome was not age itself, but primary clinical condition on admission. The therapy of symptomatic aneurysms in elderly patients should not be purely conservative—a direct approach of the aneurysm should be considered. Endovascular treatment whenever possible seems to be a good alternative to surgery.