Natural History of Unruptured Intracranial Aneurysms : A Retrospective Single Center Analysis.
10.3340/jkns.2016.59.1.11
- Author:
Hyoung Soo BYOUN
1
;
Won HUH
;
Chang Wan OH
;
Jae Seung BANG
;
Gyojun HWANG
;
O Ki KWON
Author Information
1. Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea. wanoh@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Natural history;
Intracranial aneurysms;
Rupture rate;
Risk factors
- MeSH:
Aneurysm;
Asian Continental Ancestry Group;
Cohort Studies;
Endovascular Procedures;
Follow-Up Studies;
Humans;
Intracranial Aneurysm*;
Natural History*;
Retrospective Studies*;
Risk Factors;
Rupture;
Subarachnoid Hemorrhage
- From:Journal of Korean Neurosurgical Society
2016;59(1):11-16
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We conducted a retrospective cohort study to elucidate the natural course of unruptured intracranial aneurysms (UIAs) at a single institution. METHODS: Data from patients diagnosed with UIA from March 2000 to May 2008 at our hospital were subjected to a retrospective analysis. The cumulative and annual aneurysm rupture rates were calculated. Additionally, risk factors associated with aneurysmal rupture were identified. RESULTS: A total of 1339 aneurysms in 1006 patients met the inclusion criteria. During the follow-up period, 685 aneurysms were treated before rupture via either an open surgical or endovascular procedure. Six hundred fifty-four UIAs were identified and not repaired during the follow-up period. The mean UIA size was 4.5+/-3.2 mm, and 86.5% of the total UIAs had a largest dimension <7 mm. Among these UIAs, 18 ruptured at a median of 1.6 years (range : 27 days to 9.8 years) after day 0. The annual rupture risk during a 9-year follow-up was 1.00%. A multivariate Cox proportional hazards analysis revealed that the aneurysm size and a history of subarachnoid hemorrhage (SAH) were statistically significant risk factors for rupture. For an aneurysms smaller than 7 mm in the absence of a history of SAH, the annual rupture risk was 0.79%. CONCLUSION: In our study, the annual rupture risk for UIAs smaller than 7 mm in the absence of a history of SAH was higher than that of Western populations but similar to that of the Japanese population.
