Greater Rupture Risk for Familial as Compared to Sporadic Unruptured Intracranial Aneurysms

被引:139
作者
Broderick, Joseph P. [1 ]
Brown, Robert D., Jr. [2 ]
Sauerbeck, Laura [1 ]
Hornung, Richard [3 ]
Huston, John, III [2 ]
Woo, Daniel [1 ]
Anderson, Craig [4 ]
Rouleau, Guy [5 ]
Kleindorfer, Dawn [1 ]
Flaherty, Matthew L. [1 ]
Meissner, Irene [2 ]
Foroud, Tatiana [6 ]
Moomaw, E. Charles J. [1 ]
Connolly, E. Sander [7 ]
机构
[1] Univ Cincinnati, Coll Med, Cincinnati, OH USA
[2] Mayo Clin, Rochester, MN USA
[3] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA
[4] Univ Sydney, George Inst Internatl Hlth, Sydney, NSW 2006, Australia
[5] Univ Montreal, Notre Dame Hosp, Montreal, PQ H3C 3J7, Canada
[6] Indiana Univ, Sch Med, Indianapolis, IN USA
[7] Columbia Univ, New York, NY USA
关键词
intracranial aneurysm; familial; magnetic resonance angiography; risk of rupture; smoking; NATURAL-HISTORY;
D O I
10.1161/STROKEAHA.108.542571
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-The risk of intracranial aneurysm (IA) rupture in asymptomatic members of families who have multiple affected individuals is not known. Methods-First-degree unaffected relatives of those with a familial history of IA who had a history of smoking or hypertension but no known IA were offered cerebral MR angiography (MRA) and followed yearly as part of a National Institute of Neurological Diseases and Stroke-funded study of familial IA (Familial Intracranial Aneurysm [FIA] Study). Results-A total of 2874 subjects from 542 FIA Study families were enrolled. After study enrollment, MRAs were performed in 548 FIA Study family members with no known history of IA. Of these 548 subjects, 113 subjects (20.6%) had 148 IAs by MRA of whom 5 subjects had IA >= 7 mm. Two subjects with an unruptured IA by MRA/CT angiography (3-mm and 4-mm anterior communicating artery) subsequently had rupture of their IA. This represents an annual rate of 1.2 ruptures per 100 subjects (1.2% per year; 95% CI, 0.14% to 4.3% per year). None of the 435 subjects with a negative MRA have had a ruptured IA. Survival curves between the MRA-positive and -negative cohorts were significantly different (P=0.004). This rupture rate of unruptured IA in the FIA Study cohort of 1.2% per year is approximately 17 times higher than the rupture rate for subjects with an unruptured IA in the International Study of Unruptured Aneurysm Study with a matched distribution of IA size and location 0.069% per year. Conclusions-Small unruptured IAs in patients from FIA Study families may have a higher risk of rupture than sporadic unruptured IAs of similar size, which should be considered in the management of these patients. (Stroke. 2009; 40: 1952-1957.)
引用
收藏
页码:1952 / 1957
页数:6
相关论文
共 10 条
[1]   Susceptibility loci for intracranial aneurysm in European and Japanese populations [J].
Bilguvar, Kaya ;
Yasuno, Katsuhito ;
Niemela, Mika ;
Ruigrok, Ynte M. ;
Fraunberg, Mikael von und zu ;
van Duijn, Cornelia M. ;
van den Berg, Leonard H. ;
Mane, Shrikant ;
Mason, Christopher E. ;
Choi, Murim ;
Gaal, Emilia ;
Bayri, Yasar ;
Kolb, Luis ;
Arlier, Zulfikar ;
Ravuri, Sudhakar ;
Ronkainen, Antti ;
Tajima, Atsushi ;
Laakso, Aki ;
Hata, Akira ;
Kasuya, Hidetoshi ;
Koivisto, Timo ;
Rinne, Jaakko ;
Ohman, Juha ;
Breteler, Monique M. B. ;
Wijmenga, Cisca ;
State, Matthew W. ;
Rinkel, Gabriel J. E. ;
Hernesniemi, Juha ;
Jaaskelainen, Juha E. ;
Palotie, Aarno ;
Inoue, Ituro ;
Lifton, Richard P. ;
Guenel, Murat .
NATURE GENETICS, 2008, 40 (12) :1472-1477
[2]   The Familial Intracranial Aneurysm (FIA) study protocol [J].
Broderick, JP ;
Sauerbeck, LR ;
Foroud, T ;
Huston, J ;
Pankratz, N ;
Meissner, I ;
Brown, RD .
BMC MEDICAL GENETICS, 2005, 6
[3]   Screening for brain aneurysm in the Familial Intracranial Aneurysm study: frequency and predictors of lesion detection [J].
Brown, Robert D., Jr. ;
Huston, John, III ;
Hornung, Richard ;
Foroud, Tatiana ;
Kallmes, David F. ;
Kleindorfer, Dawn ;
Meissner, Irene ;
Woo, Daniel ;
Sauerbeck, Laura ;
Broderick, Joseph .
JOURNAL OF NEUROSURGERY, 2008, 108 (06) :1132-1138
[4]   Influence of smoking, hypertension, and sex on the phenotypic expression of familial intracranial aneurysms in siblings [J].
Connolly, ES ;
Choudhri, TF ;
Mack, WJ ;
Mocco, J ;
Spinks, TJ ;
Slosberg, J ;
Lin, T ;
Huang, J ;
Solomon, RA .
NEUROSURGERY, 2001, 48 (01) :64-68
[5]   The same sequence variant on 9p21 associates with myocardial infarction, abdominal aortic aneurysm and intracranial aneurysm [J].
Helgadottir, Anna ;
Thorleifsson, Gudmar ;
Magnusson, Kristinn P. ;
Gretarsdottir, Solveig ;
Steinthorsdottir, Valgerdur ;
Manolescu, Andrei ;
Jones, Gregory T. ;
Rinkel, Gabriel J. E. ;
Blankensteijn, Jan D. ;
Ronkainen, Antti ;
Jaaskelainen, Juha E. ;
Kyo, Yoshiki ;
Lenk, Guy M. ;
Sakalihasan, Natzi ;
Kostulas, Konstantinos ;
Gottsater, Anders ;
Flex, Andrea ;
Stefansson, Hreinn ;
Hansen, Torben ;
Andersen, Gitte ;
Weinsheimer, Shantel ;
Borch-Johnsen, Knut ;
Jorgensen, Torben ;
Shah, Svati H. ;
Quyyumi, Arshed A. ;
Granger, Christopher B. ;
Reilly, Muredach P. ;
Austin, Harland ;
Levey, Allan I. ;
Vaccarino, Viola ;
Palsdottir, Ebba ;
Walters, G. Bragi ;
Jonsdottir, Thorbjorg ;
Snorradottir, Steinunn ;
Magnusdottir, Dana ;
Gudmundsson, Gudmundur ;
Ferrell, Robert E. ;
Sveinbjornsdottir, Sigurlaug ;
Hernesniemi, Juha ;
Niemela, Mika ;
Limet, Raymond ;
Andersen, Karl ;
Sigurdsson, Gunnar ;
Benediktsson, Rafn ;
Verhoeven, Eric L. G. ;
Teijink, Joep A. W. ;
Grobbee, Diederick E. ;
Rader, Daniel J. ;
Collier, David A. ;
Pedersen, Oluf .
NATURE GENETICS, 2008, 40 (02) :217-224
[6]   Unruptured Intracranial Aneurysms Incidence of Rupture and Risk Factors [J].
Ishibashi, Toshihiro ;
Murayama, Yuichi ;
Urashima, Mitsuyoshi ;
Saguchi, Takayuki ;
Ebara, Masaki ;
Arakawa, Hideki ;
Irie, Koreaki ;
Takao, Hiroyuki ;
Abe, Toshiaki .
STROKE, 2009, 40 (01) :313-316
[7]   Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture (Reprinted from Journal of Neurosurgery, vol 93, pg 379-387, 2000) [J].
Juvela, Seppo ;
Porras, Matti ;
Poussa, Kristiina .
JOURNAL OF NEUROSURGERY, 2008, 108 (05) :1052-1060
[8]   Family history of subarachnoid hemorrhage and the incidence of asymptomatic, unruptured cerebral aneurysms [J].
Nakagawa, T ;
Hashi, K ;
Kurokawa, Y ;
Yamamura, A .
JOURNAL OF NEUROSURGERY, 1999, 91 (03) :391-395
[9]   Risk of rupture of unruptured intracranial aneurysms in relation to patient and aneurysm characteristics - An updated meta-analysis [J].
Wermer, Marieke J. H. ;
van der Schaaf, Irene C. ;
Algra, Ale ;
Rinkel, Gabriel J. E. .
STROKE, 2007, 38 (04) :1404-1410
[10]   Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment [J].
Wiebers, D ;
Whisnant, JP ;
Huston, J ;
Meissner, I ;
Brown, RD ;
Piepgras, DG ;
Forbes, GS ;
Thielen, K ;
Nichols, D ;
O'Fallon, WM ;
Peacock, J ;
Jaeger, L ;
Kassell, NF ;
Kongable-Beckman, GL ;
Torner, JC ;
Naleway, A ;
Yoo, B ;
Sorensen, B ;
Wiebers, DO ;
Whisnant, JP ;
Huston, J ;
Meissner, I ;
Brown, RD ;
Piepgras, DG ;
Forbes, GS ;
Thielen, K ;
Nichols, D ;
O'Fallon, WM ;
Peacock, J ;
Jaeger, L ;
Kassell, NF ;
Kongable-Beckman, GL ;
Torner, JC ;
Wiebers, DO ;
Whisnant, JP ;
Huston, J ;
Meissner, I ;
Brown, RD ;
Piepgras, DG ;
Forbes, GS ;
Nichols, D ;
O'Fallon, WM ;
Peacock, J ;
Jaeger, L ;
Kassell, NF ;
Kongable-Beckman, GL ;
Torner, JC ;
Naleway, A ;
Drake, CG ;
Ferguson, GG .
LANCET, 2003, 362 (9378) :103-110