The comparison of complications on the endovascular and surgical treatment in elderly cerebral aneurysm patients. |
Gunn Hee Kim, Yang Hoon Chung, Myung Hee Kim, Ik Soo Chung, Jeong Jin Lee |
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea. jjlee@samsung.com |
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Abstract |
BACKGROUND The aim of this study was to compare intraoperative and postoperative complications and clinical outcome of endovascular coiling (EVT) with neurosurgical clipping (NST) under general anesthesia in the cerebral aneurysm patients older than 60 years. METHODS We retrospectively reviewed the charts, operative reports of patients who underwent EVT or NST at our hospital between January 2006 and August 2008. A total of 181 patients (EVT = 78, NST = 103) were included in this study. RESULTS The rate of intraoperative event was higher in EVT than in NST but postoperative complication and Glasgow outcome scale (GOS) at 6 months did not show statically significance in both groups. Preoperative aneurysm rupture, age and the World Federation of Neurological Surgeons grade (WFNS) were the influencing factors for outcome in both groups. Anesthetic agents, body temperature and vasoactive drugs were significantly different between the two groups but the effects of these on the outcome of patients were insignificant. CONCLUSIONS In EVT and NST, the variables related to the postoperative complications were preoperative aneurysm rupture, age and WFNS. When the elderly patients get these procedures, more close care should be considered postoperatively. |
Key Words:
Aged; Cerebral aneurysm; Endovascular treatment; General anesthesia; Neurosurgery |
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