Endovascular treatment of intracranial aneurysms using Guglielmi detachable coils (GDCs) was performed on 10 patients aged 80-89. Preoperative Hunt and Kosnik grading revealed that 4 patients were in Grade II, 4 in Grade III, and 2 in Grade IV. The aneurysms were located in the internal carotid artery in 5 patients, in the anterior communicating aneurysm in 2, in the posterior inferior cerebellar artery in 2, and in the basilar artery in 1. The approach was transfemoral in 8 patients and transcarotid in 2. Intra-aneurysmal occlusion was performed in 10 patients with total occlusion in 4, subtotal occlusion in 5 and partial occlusion in 1. Procedure-related morbidity or mortality was not observed. All patients who were successfully treated, 4 patients in Grade II and 1 in Grade III had a good outcome (GR, MD), but the other 3 patients in Grade III and 2 patients in Grade IV had a poor outcome (SD, Dead). The follow-up period ranged from 6 to 22 months. No evidence of recurrent hemorrhage was noted during follow-up.
Endovascular coil embolization, done without craniotomy, may offer particular advantages in managing ruptured intracranial aneurysms in patients over 80 years of age, especially those in Hunt and Kosnik Grade II.
