Changing paradigm in the management of elderly patients with intracranial aneurysms: An institutional review

Publication date: Available online 7 June 2017 Source:Journal of Clinical Neuroscience Author(s): Oleg Y. Chernyshev, Shyamal C. Bir, Tanmoy K. Maiti, Devi Prasad Patra, Cesar Liendo, Hugo Cuellar, Alireza Minagar, Anil Nanda Optimal treatment of intracranial aneurysms (IAs) in elderly patients has not yet been well established. We have investigated the clinical and radiological outcomes and predictors of unfavorable outcome of IAs in elderly patients. Radiological and clinical data of 85 elderly patients from 2010 through 2015 were retrospectively reviewed. Significant differences between the groups were determined by a chi-square test. Regression analysis was performed to identify the predictors of unfavorable outcome. Among the 85 patients with IAs, the number of patients with >7mm size aneurysm (p =0.01), diabetes mellitus (DM) (p =0.02), smoking (0.009) and Hunt and Hess grade 4–5 (p =0.003) was significantly higher in the ruptured group compared to the unruptured group. Similarly, the number of patients who underwent clipping was higher in the ruptured aneurysm group (p =0.01). The overall clinical outcome was comparatively better in the unruptured group (p =0.03); however, microsurgical clipping of aneurysms provides a significantly higher rate of complete aneurysmal occlusion (p =0.008). Overall, there was no significant difference in outcome in respect to treatment approach. In regression analysis, hypertension (HTN), obstructive sleep apnea (OSA),...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research