脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
原  著
年齢による未破裂脳動脈瘤の治療成績
石川 達也山口 浩司松岡 剛富永 禎弼大村 佳大宮尾 暁菊田 敬央岡 美栄子川俣 貴一
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2017 年 45 巻 5 号 p. 385-388

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The aim of this study was to determine age-related differences in outcome between clipping and coiling in patients with intracranial aneurysms. We retrospectively analyzed 377 consecutive patients (clipping, 304 cases and coiling, 73 cases) dividing them into four groups based on age as follows: <50 years, 50 to 59 years, 60 to 69 years, and ≥70 years. Outcomes were assessed in the perioperative period and 1 year later. Of the cases with perioperative symptomatic events, 7 (2.3%), including 4 cases (1.3%) of symptomatic ischemic stroke, were treated with clipping and none was treated with coiling. All cases of symptomatic perioperative ischemic stroke after clipping occurred in patients aged 60 years (p = 0.027). Events at 1 year occurred only after clipping in 10 cases (3.3%) and after coiling in none of the cases. Eight of 10 patients had chronic subdural hematoma, and all of them were >60 years old (p = 0.028). Favorable outcome was observed for both clipping and coiling in both age groups. Clipping was related to risks of perioperative ischemic stroke and chronic subdural hematoma within 1 year in patients >60 years of age.
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© 2017 一般社団法人 日本脳卒中の外科学会
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