Intracranial Aneurysms in Makassar, Indonesia: Unveiling Rupture Risk Characteristics

Abstract

Background: The substantial illness and mortality resulting from subarachnoid hemorrhage are attributed to the rupture of an intracranial aneurysm (IA). Some researchers have suggested that IA morphology predicts rupture. The objective of this research was to assess the morphological attributes of both ruptured and unruptured aneurysms and determine the variables linked to a higher probability of rupture. We retrospectively gathered cases of IAs at Dr. Wahidin Sudirohusodo General Hospital Makassar between January 2020 and December 2023 for this study. We obtained information from radiography, catheter lab, and patient medical records. We considered gender, age, locality, hypertension, and demographic traits. We assessed numerous morphological characteristics using three-dimensional angiograms, including the parent’s artery diameter, the maximum height, the dimensions of the aneurysm neck, the size ratio, the aspect ratio, the height–width ratio, and the existence of a daughter sac. We analyzed aneurysm features linked to aneurysm rupture using a cross-sectional methodology. Results: This research comprised a total of 68 individuals with IAs, with 48 patients having ruptured aneurysms and 20 patients having unruptured aneurysms. We observed substantial differences in aneurysm size (maximum aneurysm width), location, age, and hypertension between the groups with ruptured and unruptured aneurysms. We found a significant association between the risk of rupture and older age (56 ± 9.23; P = 0.048), hypertension (P = 0.003), and the location in Acom/Pcom (P = 0.001). The mean aneurysm size of the ruptured IAs (4.42 ± 1.97 mm) was significantly smaller than the unruptured IAs (8.64 ± 6.51 mm; P = 0.03). Conclusion: According to this study, even smaller aneurysms in Acom/Pcom patients with hypertension who are older are more likely to rupture.