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AJNR - American Journal of Neuroradiology

Published ahead of print on June 12, 2008
doi: 10.3174/ajnr.A1165

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Endovascular Treatment of Intracranial Aneurysms in Patients 65 Years or Older: Clinical Outcomes

E.R. Gizewski^a, S. Göricke^a, A. Wolf^a, B. Schoch^b, D. Stolke^b, M. Forsting^a and I. Wanke^a

^a Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
^b Clinic of Neurosurgery, University Hospital Essen, Essen, Germany

View larger version (25K): [in this window] [in a new window]   Fig 1. The outcome of all patients treated with endovascular therapy for aneurysms is plotted against HH grading and given in percentages of all patients.

View larger version (47K): [in this window] [in a new window]   Fig 2. A, In this figure, the distribution of 3 age groups is plotted for the GOS values GR, MD, SD, and D. V was not plotted because this group was too small for relative calculations. B, In this figure, the distribution of HH grades are plotted for the GOS values GR, MD, SD, and D. V was not plotted because this group was too small for relative calculations.

View larger version (117K): [in this window] [in a new window]   Fig 3. A, DSA of a 73-year-old woman with an incidentally discovered aneurysm at the left ICA. B, After insertion of the guiding catheter, a thrombotic occlusion of the left MCA occurred. C, Therefore, the patient was first treated with local fibrinolysis therapy. D, Control DSA at the end of the coiling procedure revealed a complete occlusion of the aneurysm and a regular perfusion in the left hemisphere. The initial MR imaging 2 days after coiling did reveal a small infarct in the MCA territory.

View larger version (53K): [in this window] [in a new window]   Fig 4. A, DSA of 70-year-old woman with an incidentally discovered wide-necked basilar tip aneurysm. The endovascular procedure consisted of a Neuroform stent deployment and subsequent coiling. B, A small residual opacification was noted after the treatment. C, The follow-up angiogram after 6 months revealed subsequent thrombosis resulting in a complete occlusion of the aneurysm and in-stent stenosis of the P1 segment on the right.