80歳以上の超高齢者破裂脳動脈瘤に対するGDC塞栓術

概要

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Endovascular treatment of intracranial aneurysms using Guglielmi detachable coils (GDCs) was performed on 10 patients aged 80-89. Preoperative Hunt and Kosnik grading revealed that 4 patients were in Grade II, 4 in Grade III, and 2 in Grade IV. The aneurysms were located in the internal carotid artery in 5 patients, in the anterior communicating aneurysm in 2, in the posterior inferior cerebellar artery in 2, and in the basilar artery in 1. The approach was transfemoral in 8 patients and transcarotid in 2. Intra-aneurysmal occlusion was performed in 10 patients with total occlusion in 4, subtotal occlusion in 5 and partial occlusion in 1. Procedure-related morbidity or mortality was not observed. All patients who were successfully treated, 4 patients in Grade II and 1 in Grade III had a good outcome (GR, MD), but the other 3 patients in Grade III and 2 patients in Grade IV had a poor outcome (SD, Dead). The follow-up period ranged from 6 to 22 months. No evidence of recurrent hemorrhage was noted during follow-up. Endovascular coil embolization, done without craniotomy, may offer particular advantages in managing ruptured intracranial aneurysms in patients over 80 years of age, especially those in Hunt and Kosnik Grade IT.
日本脳卒中の外科学会の論文
2002-01-31