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Metayer T, Blanc R, Smajda S, Desilles JP, Redjem H, Escalard S, Mazighi M, Tayeb AA, Robichon E, Raaisi AA, Boisseau W, Delvoye F, Piotin M. Treated unruptured cerebral aneurysm in elderly patients: a single center study. Neurochirurgie 2024; 70:101522. [PMID: 38101026 DOI: 10.1016/j.neuchi.2023.101522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023]
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.
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Affiliation(s)
- Thomas Metayer
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000 Caen, France.
| | - Raphael Blanc
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - Stanislas Smajda
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - Jean Philippe Desilles
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France; Laboratory of Vascular Translational Science, U1148 INSERM, Paris, France
| | - Hocine Redjem
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - Simon Escalard
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - Mikael Mazighi
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France; Laboratory of Vascular Translational Science, U1148 INSERM, Paris, France
| | - Adnan Al Tayeb
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - Erwan Robichon
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - Amira Al Raaisi
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - William Boisseau
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
| | - Francois Delvoye
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France; University of Liège, Liège, Belgium
| | - Michel Piotin
- Department of Neuroradiology, Rothschild Foundation Hospital, Paris, F-75019, France
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