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Anatomical and morphological factors correlating with rupture of intracranial aneurysms in patients referred for endovascular treatment
Authors:G J Hademenos  T F Massoud  F Turjman  J W Sayre
Institution:(1) Division of Interventional Neuroradiology, Department of Radiological Sciences, UCLA School of Medicine and Medical Center, Los Angeles, USA, US;(2) Departments of Biostatistics and Radiological Sciences, UCLA School of Medicine Medical Center, Los Angeles, California, USA, US;(3) Science and Medicine, American Heart Association National Center, 7272 Greenville Avenue, Dallas TX 75231-4596, USA Tel.: +1-2 14-7 06-16 12 Fax: +1-2 14-3 73-02 68 e-mail: georgeh@heart.org, US
Abstract:The size of intracranial aneurysms is the only characteristic shown to correlate with their rupture. However, the critical size for rupture has varied considerably among previous accounts and remains a point of controversy. Our goal was to identify statistically significant clinical and morphological factors predictive of the occurrence of rupture and aneurysm size in patients referred for endovascular treatment. We retrospectively recorded the following factors from 74 patients who presented with ruptured (40) or unruptured (34) aneurysms: aneurysm morphology (uni/multilobulated), location (anterior/posterior), maximum diameter, diameter of the neck, and the patient's age and sex. We performed stepwise discriminant, and stepwise and logistic regression analysis to identify factors predicting rupture and the size of the aneurysm at rupture. The mean diameter of the ruptured aneurysms was 11.9 ± 6.3 mm, range 3.0–33.0 mm, and that of the unruptured aneurysm 13.5 ± 5.8 mm, range 5.0–30 mm. Stepwise discriminant analysis identified aneurysm morphology (P < 0.001) and location in the intracranial circulation (P < 0.001) as statistically significant factors in predicting rupture. Stepwise regression analysis revealed that aneurysm morphology and the size of the neck were predictors of aneurysm size at rupture. Received: 30 December 1997 Accepted: 28 April 1998
Keywords:Aneurysm  intracranial  Natural history  Hemorrhage
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