rE-TREATMENT OF CEREBRAL ANEURYSMS WHICH UNDERWENT ENDOVASCULAR COIL EMBOLIZATION AS INITIAL TREATMENT IN ELDERLY PATIENTS: INCIDENCE, RISK FACTORS AND RESULTS IN A SINGLE CENTER

Abstract

Objective The purpose of this study is to investigate incidence, risk factors and results of re-treated cerebral aneurysms which underwent endovascular coil embolization as initial treatment in elderly patients. Methods All patients who had received coil embolization of an intracranial aneurysm at our own hospital, who have follow-up period of at least 1 year and are above 65 years old were included in this study. Univariate and multivariate logistic regression analysis for results were performed. Results From Mar. 2002 to Feb. 2014, 312 consecutive patients underwent endovascular coil embolization for cerebral aneurysms at our hospital. Among them, total of 37 aneurysms (11.9%) were re-treated. Two patients were re-treated for newly developed hemorrhage (5.4%), 25 for aneurysm regrowth (67.6%), 10 for coil compaction and/or recanalization (27%) with mean interval between coiling to re-treatment 2.4 years. Risk factors for re-treatment were initial complete occlusion (odds ratio [OR], 0.400; 95% confidence interval [CI], 0.195-0.821), hypertension (OR, 2.695; 95% CI, 1.316-5.519), initial rupture status (OR, 2.609, 95% CI, 1.271-5.359). Conclusion This is the first study of aneurysm re-treatment confined to elderly patients. Hypertension, initial rupture status and initial incomplete aneurysm occlusion status were risk factors for re-treatment after endovascular treatment. Re-treatment of cerebral aneurysms after initial coil embolization does not cause significant additional morbidity and mortality in elderly.