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Acta Neurochirurgica

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01-12-2024 | Aneurysm | Original Article

Risk factors of unruptured intracranial aneurysms instability in the elderly

Authors: Simin Wang, Jiewen Geng, Yadong Wang, Wenzhi Wang, Peng Hu, Chuan He, Hongqi Zhang

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Background

Presently, a consistent strategy for determining the stability of unruptured intracranial aneurysms (UIAs) in elderly patients is lacking, primarily due to the unique characteristics of this demographic. Our objective was to assess the risk factors contributing to aneurysm instability (growth or rupture) within the elderly population.

Methods

In this study, we compiled data from follow-up patients with UIAs spanning from November 2016 to August 2021. We specifically focused on patients aged ≥ 60 years. Clinical histories were gathered, and morphological parameters of aneurysms were measured. The growth of aneurysms was determined using the computer-assisted semi-automated measurement (CASAM). Growth and rupture rates of UIAs were calculated, and both univariate and multivariate Cox regression analyses were conducted. Additionally, Kaplan–Meier survival curves were plotted.

Results

A total of 184 patients with 210 aneurysms were enrolled in the study. The follow-up period encompasses 506.6 aneurysm-years and 401.4 patient-years. Among all the aneurysms, 23 aneurysms exhibited growth, with an annual aneurysm growth rate of 11.0%, and 1 (4.5%) experienced rupture, resulting in an annual aneurysm rupture rate of 0.21%. Multivariate Cox analysis identified poorly controlled hypertension (P = 0.011) and high-risk aneurysms (including anterior cerebral artery (ACA), anterior communicating artery (AcoA), posterior communicating artery aneurysm (PcoA), posterior circulation (PC) > 4 mm or distal internal carotid artery (ICAd), middle cerebral artery (MCA), and PC > 7 mm) (P = 0.006) as independent risk factors for the development of unstable aneurysms.

Conclusions

In the elderly, poorly controlled hypertension and high-risk aneurysms emerge as significant risk factors for aneurysm instability. This underscores the importance of rigorous surveillance or timely intervention in patients presenting with these risk factors.

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Title: Risk factors of unruptured intracranial aneurysms instability in the elderly
Authors: Simin Wang
Jiewen Geng
Yadong Wang
Wenzhi Wang
Peng Hu
Chuan He
Hongqi Zhang
Publication date: 01-12-2024
Publisher: Springer Vienna
Keywords: Aneurysm
Aneurysm
Intracranial Aneurysm
Hypertension
Hypertension
Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-05901-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors of unruptured intracranial aneurysms instability in the elderly

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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