Association between underlying autoimmune disease and small aneurysm size at rupture

Area of Science:

• Neurology
• Immunology
• Vascular Surgery

Background:

• Inflammation plays a known role in aneurysm development.
• The specific impact of autoimmune diseases on intracranial aneurysms is less understood.
• Systemic inflammatory conditions may share pathways with aneurysm formation.

Purpose of the Study:

• To investigate the association between autoimmune diseases and the growth and rupture of intracranial aneurysms.
• To explore if autoimmune diseases influence aneurysm size and rupture characteristics.

Main Methods:

• Retrospective review of medical records for patients undergoing cerebral angiography (August 2018 - August 2021).
• Inclusion criteria: patients with systemic autoimmune diseases affecting the central nervous system or multiple organ systems.
• Statistical analysis using multivariable linear and logistic regression models (R version 4.1.0).

Main Results:

• 31 patients (44 aneurysms) with autoimmune disease were identified among 190 patients.
• Aneurysms in patients with autoimmune disease were significantly smaller at rupture (mean 4.14 mm vs 5.34 mm).
• Autoimmune disease was independently associated with rupture at sizes smaller than 7 mm, while smoking was linked to larger rupture sizes (>7 mm).

Conclusions:

• Autoimmune disease correlates with smaller aneurysm size at rupture but not rupture occurrence.
• Common inflammatory pathways may explain the link between autoimmune conditions and aneurysm wall development.
• The association of autoimmune disease with smaller rupture size warrants further investigation into its influence on aneurysm progression and treatment strategies.