Improved Endovascular Coiling of Wide-Neck Intracranial Aneurysms in Elderly Patients by Double-Microcatheter Technique.

Abstract

Elderly patients are more susceptible to intracranial aneurysms. However, many of them are poor surgical candidates and often have to undergo endovascular treatment. The purpose of this study was to evaluate the efficacy and safety of double-microcatheter technique as an alternative to a balloon- or stent-assisted techniques for wide-neck aneurysms in elderly patients. A retrospective review of 58 patients with 58 wide-neck aneurysms treated with the double-microcatheter technique between October 2010 and December 2012 was performed. Immediate post-embolization angiograms were evaluated using a conventional angiographic scale, and clinical evaluation was performed using the Glasgow Outcome Scale. Clinical and imaging follow-ups were available in 32 (55%) patients, with a mean of 12.5 months. Post-embolization angiograms demonstrated total occlusion in 46 of 58 (79%) aneurysms, a neck remnant in 7 (13%), and body filling in 5 (8%). The technique-related complication rate was 5% (3/58), and the procedural-related mortality rate was 0. Of the 32 aneurysms with follow-ups, recanalization developed in 3 (9%) aneurysms, and none received re-treatment. Using double-microcatheter technique for embolization of wide-neck intracranial aneurysms is safe and effective in the elderly patients. This technique is feasible and safe for coil embolization of wide-neck aneurysms, especially in cases, which are not suitable for balloon- or stent-assisted techniques.