Risk of Rupture After Intracranial Aneurysm Growth

• DOI: 10.1001/jamaneurol.2021.2915
• Publication Date: 2021-08-30T15:32:55Z
• Authors: Laura T. van der ...; Gabriel J. E. Rinkel; Dagmar Verbaan; René van den Berg; W. Peter Vandertop; Yuichi Murayama; Toshihiro Ishibashi; Antti Lindgren; Timo Koivisto; Mario Teo; Jerome St George; Ronit Agid; Ivan Radovanovic; Junta Moroi; Keiji Igase; Ido R. van den Wi...; Melissa Rahi; Jaakko Rinne; Johanna Kuhmonen; Hieronymus D. Boo...; George K. C. Wong; Jill M. Abrigo; Akio Morita; Yoshiaki Shiokawa; Katharina A. M. H...; Nima Etminan; Irene C. van der ...; Nicolaas P. A. Zu...; Mervyn D. I. Verg...
• Keywords: Fusiform Aneurysm

Unruptured intracranial aneurysms not undergoing preventive endovascular or neurosurgical treatment are often monitored radiologically to detect aneurysm growth, which is associated with an increase in risk of rupture. However, the absolute rupture after detection growth remains unclear. To determine during follow-up and develop a prediction model for Individual patient data were obtained from 15 international cohorts. Patients 18 years older who had imaging at least 1 untreated unruptured detected day longer included. Fusiform arteriovenous malformation-related excluded. Of 5166 eligible patients aneurysms, 4827 excluded because no was detected, 27 they less than growth. All included defined as mm greater direction imaging. The primary outcome measured Kaplan-Meier estimate 3 time points (6 months, year, 2 years) initial Cox proportional hazards regression used identify predictors detection. A total 312 (223 [71%] women; mean [SD] age, 61 [12] 329 During 864 aneurysm-years follow-up, 25 (7.6%) these ruptured. 2.9% (95% CI, 0.9-4.9) 6 4.3% 1.9-6.7) 6.0% 2.9-9.1) years. In multivariable analyses, size (7 larger hazard ratio, 3.1; 95% 1.4-7.2), shape (irregular 2.9; 1.3-6.5), site (middle cerebral artery 3.6; 0.8-16.3; anterior artery, posterior communicating circulation 2.8; 0.6-13.0). triple-S (size, site, shape) model, 1-year ranged 2.1% 10.6%. Within year detection, occurred approximately aneurysms. can be period