Affiliation:
1. From the Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (A.S.E.B., A.T.T.G., G.J.E.R.); Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada (A.T.T.G., K.G.t., R.A.); Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands (B.K.V.); and Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (M.J.H.W.).
Abstract
Background and Purpose—
Unruptured intracranial aneurysms are frequently followed to monitor aneurysm growth. We studied the yield of follow-up imaging and analyzed risk factors for aneurysm growth.
Methods—
We included patients with untreated, unruptured intracranial aneurysms and ≥6 months of follow-up imaging from 2 large prospectively collected databases. We assessed the proportion of patients with aneurysm growth and performed univariable and multivariable Cox regression analyses to calculate hazard ratios with corresponding 95% confidence intervals (CI) for clinical and radiological risk factors for aneurysm growth. We repeated these analyses for the subset of small (<7 mm) aneurysms.
Results—
Fifty-seven (12%) of 468 aneurysms in 363 patients grew during a median follow-up of 2.1 years (total follow-up, 1372 patient-years). In multivariable analysis, hazard ratios for aneurysm growth were as follows: 1.1 (95% CI, 1.0–1.2) per each additional mm of initial aneurysm size; 2.7 (95% CI, 1.2–6.4) for dome > neck ratio; 2.1 (95% CI, 0.9–4.9) for location in the posterior circulation; and 2.0 (95% CI, 0.8–4.8) for multilobarity. In the subset of aneurysms <7 mm, 37 of 403 (9%) enlarged. In multivariable analysis, hazard ratios for aneurysm growth were 1.1 (95% CI, 0.8–1.5) per each additional mm of initial aneurysm size, 2.2 (95% CI, 1.0–4.8) for smoking, 2.9 (95% CI, 1.0–8.5) for multilobarity, 2.4 (95% CI, 1.0–5.8) for dome/neck ratio, and 2.0 (95% CI, 0.6–7.0) for location in the posterior circulation.
Conclusions—
Initial aneurysm size, dome/neck ratio, and multilobarity are risk factors for aneurysm growth. Cessation of smoking is pivotal because smoking is a modifiable risk factor for growth of small aneurysms.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology
Cited by
77 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献