The impact of microsurgical clipping and endovascular coiling on the outcome of cerebral aneurysms in patients over 60 years of age.

A retrospective study was performed to compare the safety and efficacy in elderly patients of endovascular coiling, with clipping, for cerebral aneurysms. In total, 198 patients over 60 years of age with ruptured intracranial aneurysms were treated by microsurgical clipping (n=122) or endovascular coiling (n=76). Endovascular coiling achieved favorable outcome in 88.2% of patients, which was significantly higher than for the microsurgical clipping group. The occurrence of re-bleeding, infarction, and hydrocephalus was similar between the two groups. Intraoperative time for microsurgical clipping was significantly longer than that for endovascular coiling. Length of hospitalization was shorter for the coiling group than for the clipping group. Our results suggest that endovascular coiling should be considered as the first-choice therapy in elderly patients with ruptured aneurysms, as it may reduce duration of both the operation and hospitalization.