高齢者重症くも股下出血に対する急性期脳血管内手術の治療成績(<特集>高齢者重症くも膜下出血の急性期治療)  [in Japanese] Clinical Results of Endovascular Coil Embolization on Acute Stage for Elderly Patients with Subarachnoid Hemorrhage in Poor Neurological Grades(<Topics>Treatment for the Elderly with Severe SAH)  [in Japanese]

It has been believed that clinical outcomes of the elderly subarachnoid hemorrhage (SAH) patients in poor grades are quite unsatisfactory. Recently, endovascular coil embolization is available for such patients as a less invasive treatment. In this study, we retrospectively analyzed clinical outcome of SAH patients in poor grades who were treated with endovascular coil embolization. Among 54 patients (≧75 years) presenting aneurysmal SAH who underwent early endovascular coil embolization, 24 patients in WFNS Grade IV or V were analyzed. Nineteen patients were in Grade IV, and 5 patients in Grade V. In all the patients, the dome of the aneurysm was successfully embolized with detachable coils. The degree of occlusion of the treated aneurysm was complete occlusion in 21%, neck remnant in 33%, dome filling in 25%, and partial in 21%. The rate of procedural complication was 8.3%. Outcome after 6 months was favorable in 37% of Grade IV and 40% in Grade V, respectively. Endovascular coil embolization was successfully performed in elderly SAH patients in poor neurological grades with a high level of technical success and acceptable clinical outcomes.