高齢者破裂脳動脈瘤に対するGDC塞栓術

概要

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We performed endovascular treatment of ruptured intracranial aneurysms with GDC in 11 patients over 70 years of age (ranging from 70 to 89 years old). Hunt & Kosnik grading was II in 2 patients, III in 4, IV in 2, and V in 3, respectively. The aneurysms were located in the internal carotid artery in 4 patients, in the anterior communicating artery in 4, in the posterior inferior cerebellar artery in 2, and in the basilar artery in 1. The approach was transfemoral in 8, transcarotid in 2 and transbrachial in 1. In 1 patient, GDC placement could not be done due to difficulty of catheter placement. Complete occlusion of the aneurysmal body was accomplished in 6 although a small neck remnant was observed in 2. Body filling was observed in 4. Procedure-related morbidity or mortality was not observed. The follow-up period ranged from 2 to 22 months. Recurrent hemorrhage was not observed. In the 7 patients with Grade II, III, and IV, 5 patients showed good recovery or moderate disability. All 3 patients with Grade V died. Cause of death was severe subarachnoid hemorrhage in 3, acute myocardial infarction in 1, and cerebral vasospasm in 1. GDC embolization is a useful therapeutic alternative for treatment of ruptured intracranial aneurysm in elderly patients.
日本脳卒中の外科学会の論文
2001-03-31