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Risk Factors for Intraprocedural Rerupture during Embolization of Ruptured Intracranial Aneurysms
1Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.
Journal of Korean Medical Science
|December 14, 2020
Summary
Intraprocedural rupture (IPR) during endovascular treatment of ruptured cerebral aneurysms is linked to irregular aneurysm shape, smaller size (≤3.4 mm), delayed intervention (>2 days), and vasospasm. Identifying these risk factors helps minimize IPR complications.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Neurology
Background:
- Intraprocedural rupture (IPR) is a severe complication during endovascular treatment of ruptured intracranial aneurysms.
- Risk factors for IPR remain incompletely understood, necessitating further investigation.
Purpose of the Study:
- To identify independent risk factors associated with IPR during the endovascular embolization of ruptured cerebral aneurysms.
Main Methods:
- A retrospective analysis of 1,494 patients undergoing endovascular embolization for ruptured intracranial aneurysms.
- Logistic regression and receiver operating characteristic (ROC) curve analyses were used to identify and validate risk factors for IPR.
Main Results:
- IPR occurred in 2.7% of patients (41 cases).
- Independent risk factors for IPR included irregular aneurysm morphology, aneurysm size ≤ 3.4 mm, time from symptom onset to intervention > 2 days, and intraprocedural vasospasm.
- ROC analysis confirmed predictive values for aneurysm size (cutoff 3.4 mm) and time to intervention (cutoff 2 days).
Conclusions:
- Irregular morphology, small size (≤3.4 mm), delayed intervention (>2 days), and vasospasm are significant risk factors for IPR.
- Increased vigilance for these factors is crucial to mitigate IPR risk in patients with ruptured aneurysms.
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