Impact of age on cerebral aneurysm occlusion after flow diversion
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Authors
Kuhn, Anna LuisaKan, Peter
Henninger, Nils
Srinivasan, Visish
de Macedo Rodrigues, Katyucia
Wakhloo, Ajay K.
Gounis, Matthew J.
Puri, Ajit S.
UMass Chan Affiliations
Department of NeurologyNew England Center for Stroke Research
Division of Neuroimaging and Intervention, Department of Radiology
Document Type
Journal ArticlePublication Date
2019-07-01Keywords
AgeFlow diverter
Intracranial aneurysm
Occlusion
Pipeline embolization device
Stent
Unruptured
Cardiovascular Diseases
Equipment and Supplies
Nervous System Diseases
Neurology
Radiology
Surgical Procedures, Operative
Therapeutics
Metadata
Show full item recordAbstract
The purpose of this study was to evaluate safety and efficacy of the pipeline embolization device (PED) in different patient age groups with unruptured intracranial aneurysms (UIA). All patients with UIA treated with the PED between 2011 and 2017 were included. Based on their age, patients were trichotomized to: young ( < /=45years), middle-aged (46 to < 65years) and older ( > /=65years) groups. Patient's vascular risk factors, presenting symptoms and mRS on admission were collected. Follow-up imaging was evaluated for presence/absence of aneurysm occlusion. Clinical outcome at discharge, 3-9months and 12-18months was also documented when available. A total of 260 patients harboring 307 aneurysms (young=57, middle-age=144 and older age group=64). Most aneurysms were located in the anterior circulation (94.8%). Overall morbidity and mortality was 2.3% each (6/260). At 3-9 months near complete to complete aneurysm occlusion was 82.5% (47/57) in the young age group, 82.6% (100/121) in the middle age, and 70.2% (40/57) in the older age group. At 12-18-month, near complete to complete occlusion was 100% in the young age group (32/32), 91.4% (64/70) in the middle age, and 78.4% (29/37) in the older age group. After adjustment for potential confounders, older age patients less frequently achieved near complete to complete occlusion by 3 years than younger subjects (p=0.009, HR 1.34 95%, CI 1.08-1.66). Our results indicate feasibility and safety of PED across different age groups. Further study is required to determine age-related factors relating to aneurysm occlusion after PED to improve outcome and patient counseling.Source
J Clin Neurosci. 2019 Jul;65:23-27. doi: 10.1016/j.jocn.2019.04.024. Epub 2019 May 6. Link to article on publisher's site
DOI
10.1016/j.jocn.2019.04.024Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48363PubMed ID
31072739Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/j.jocn.2019.04.024