Clinical, Radiological, and Flow-Related Risk Factors for Growth of Untreated, Unruptured Intracranial Aneurysms
- 1 January 2015
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 46 (1), 42-48
- https://doi.org/10.1161/strokeaha.114.005963
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 ( 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.Keywords
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