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Prevalence of Intracranial Aneurysms in Patients With Coarctation of the Aorta: A Systematic Review and Meta-Analysis

Alvan D Buckley1, Kevin Yo Han Um1, Javier I Ganame1

  • 1Division of Cardiology, McMaster University, Hamilton, Ontario, Canada.

JACC. Advances
|June 28, 2024
PubMed

Insights

Intracranial aneurysms (IAs) affect 3.8% of patients with coarctation of the aorta (CoA). Hypertension is a risk factor, but routine screening for IAs in CoA patients is likely low-value.

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Coarctation of the aorta (CoA) is linked to intracranial aneurysms (IAs).
  • Prevalence and risk factors for IAs in CoA patients are not well-defined.
  • Current guidelines offer conflicting recommendations for IA screening in CoA patients.

Purpose of the Study:

  • To determine the prevalence of IAs in patients with CoA.
  • To identify risk factors associated with IA development in CoA patients.

Main Methods:

  • Systematic review and meta-analysis of cohort studies.
  • Included studies utilized computed tomography or magnetic resonance angiography for IA screening.
  • Five cohort studies with 442 patients were analyzed.

Main Results:

  • The pooled prevalence of IAs in patients with CoA was 3.8%.
  • Hypertension was identified as a significant risk factor for IAs (OR 3.1, P=0.03).
  • A downward trend in IA prevalence was observed over time across studies.

Conclusions:

  • IA development in CoA is likely multifactorial, with potential modifiable risk factors.
  • Given the low pooled prevalence, routine IA screening in CoA patients may offer low value.
  • Further research into modifiable risk factors is warranted.
Abstract

Keywords:
angiographycongenital heart diseasescreening

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