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Risk factors for ruptured intracranial aneurysms
Guang-Xian Wang1, Dong Zhang1, Zhi-Ping Wang1
1Department of Radiology, Xinqiao Hospital, Third Military Medical University, Chongqing, PR China.
The Indian Journal of Medical Research
|May 12, 2018
Summary
Predicting unruptured intracranial aneurysm (IA) rupture is crucial. Bifurcation location, irregular shape, and high aspect ratio increase IA rupture risk, while cerebral atherosclerosis, internal carotid artery location, and larger neck width are protective.
Area of Science:
- Neurosurgery
- Radiology
- Vascular Medicine
Background:
- Unruptured intracranial aneurysms (IAs) pose a clinical challenge due to controversial treatment strategies.
- Predicting IA rupture risk is essential for informed clinical decision-making.
Purpose of the Study:
- To identify and evaluate the predictive value of various risk factors associated with IA rupture.
- To enhance the understanding of factors influencing the likelihood of IA rupture.
Main Methods:
- Retrospective analysis of 379 patients with 441 aneurysms (August 2011 - July 2014).
- Assessment of risk factors using clinical data and computed tomography angiography (CTA).
- Statistical methods, including multivariate logistic regression and ROC analysis, were employed.
Main Results:
- Factors negatively correlated with rupture risk include age, hypertension, heart disease, diabetes, cerebral atherosclerosis, internal carotid artery (ICA) location, and neck width (N).
- Factors positively correlated with rupture risk include anterior communicating artery location, bifurcation, irregularity, daughter sac, aneurysm height, maximum size, aspect ratio (AR), height-to-width ratio, and bottleneck factor.
- Multivariate analysis identified bifurcation, irregular shape, and high AR as increasing rupture risk, while cerebral atherosclerosis, ICA location, and greater N were protective.
Conclusions:
- Cerebral atherosclerosis, ICA location, and larger neck width act as protective factors against IA rupture.
- Bifurcation location, irregular aneurysm shape, and increased aspect ratio are significant indicators of higher rupture risk.
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