Multivariable analysis on factors associated with aneurysm rupture in patients with multiple intracranial aneurysms
- PDF / 388,005 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 24 Downloads / 187 Views
ORIGINAL ARTICLE
Multivariable analysis on factors associated with aneurysm rupture in patients with multiple intracranial aneurysms Afonso C. P. Liberato 1 & Jing Xu 1 & Daniel Montes 1 & Jeremy J. Heit 2 & Isabelle Barnaure 1,3 & Noor M. Maza 1 & Hui Zheng 4 & Joshua A. Hirsch 5 & R. Gilberto González 1 & Javier M. Romero 1 Received: 4 March 2020 / Accepted: 6 May 2020 # American Society of Emergency Radiology 2020
Abstract Purpose Multiple intracranial aneurysms (MIA) occur in one-third of patients with intracranial aneurysms (IA), and have been previously associated with an overall worse prognosis. Risk factors for IA formation and rupture in patients with a single IA are well-known. However, risk factors associated with rupture in patients with MIA have been less studied. Methods We performed a retrospective search of patients with MIA identified by computed tomography angiography (CTA) within a 10-year period. Patients with > 1 saccular aneurysm with size ≥ 2.0 mm were included. The location, size, number, and rupture status of the aneurysms were recorded. Patient demographics and cerebrovascular risk factors were obtained from electronic medical records. The primary endpoint of this study was to determine the association of these factors with aneurysmal rupture. The case-fatality rate was evaluated as a secondary outcome. Results Of the 2957 patients with IA in our CTA database, 425 patients were diagnosed with MIA and were therefore included in our study. A total of 1082 aneurysms were identified. Predictors of increased risk of aneurysmal rupture were age (OR 0.98, 95% CI, 0.96–0.99), size ≥ 5 mm (OR 4.4, 95% CI 2.76–7.0); and location in the anterior communicating artery complex (AcomC) (OR 2.62, 95% CI, 1.46–4.72) or posterior communicating artery (PCOM) (OR 2.66, 95% CI, 1.45–4.87). Conclusions Younger age, aneurysm size ≥ 5 mm, and location in the AcomC and PCOM were independently associated with aneurysmal rupture in patients with MIA. Identifying these features could help recognize patients who might benefit from early intervention. Keywords Stroke . Subarachnoid hemorrhage . Aneurysm . Risk factors . Brain
Introduction Despite the implementation of multiple screening and therapeutic interventions in the past decades, the mortality of
* Javier M. Romero [email protected] 1
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
2
Department of Radiology, Neurointerventional Radiology Division, Stanford University Medical Center, Stanford, CA 940305, USA
3
Division of Neuroradiology, Geneva University Hospitals, CH 1211, 14 Geneva, Switzerland
4
Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, USA
5
Department of Interventional Neuroradiology, Massachusetts General Hospital, Boston, MA 02114, USA
ruptured intracranial aneurysms (AI) remains high, with rates oscillating between 15 and 30% [1]. Aneurysmal subarachnoid hemorrhage (aSAH) carries high morbidity, and a recent study reports that up to
Data Loading...
