Predictors of Occurrence and Anatomic Distribution of Multiple Aneurysms in Patients with Aneurysmal Subarachnoid Hemorrhage

被引:13
|
作者
Roethlisberger, Michel [1 ]
Achermann, Rita [2 ]
Bawarjan, Schatlo [3 ]
Stienen, Martin N. [4 ]
Fung, Christian [5 ]
D'Alonzo, Donato [6 ]
Maldaner, Nicolai [4 ]
Ferrari, Andrea [7 ]
Corniola, Marco V. [8 ]
Schoni, Daniel [5 ]
Valsecchi, Daniele [9 ]
Maduri, Rodolfo [10 ]
Seule, Martin A. [7 ]
Burkhardt, Jan-Karl [11 ]
Marbacher, Serge [6 ]
Bijlenga, Philippe [8 ]
Blackham, Kristine A. [12 ]
Bucher, Heiner C. [2 ]
Mariani, Luigi [1 ]
Guzman, Raphael [1 ]
Zumofen, Daniel W. [1 ,12 ]
机构
[1] Univ Basel, Basel Univ Hosp, Dept Neurosurg, Basel, Switzerland
[2] Univ Basel, Basel Univ Hosp, Dept Clin Epidemiol & Biostat, Basel, Switzerland
[3] Univ Gottingen, Univ Med Ctr Gottingen, Dept Neurosurg, Gottingen, Germany
[4] Univ Zurich, Zurich Univ Hosp, Dept Neurosurg, Zurich, Switzerland
[5] Univ Bern, Inselspital, Dept Neurosurg, Bern, Switzerland
[6] Kantonsspital Aarau, Dept Neurosurg, Aarau, Switzerland
[7] Kantonsspital St Gallen, Dept Neurosurg, St Gallen, Switzerland
[8] Univ Geneva, Geneva Univ Hosp, Dept Neurosurg, Geneva, Switzerland
[9] Osped Civ Lugano, Dept Neurosurg, Lugano, Switzerland
[10] Univ Lausanne, Lausanne Univ Hosp, Dept Clin Neurosci, Serv Neurosurg, Lausanne, Switzerland
[11] Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA
[12] Univ Basel, Basel Univ Hosp, Dept Radiol, Div Diagnost & Intervent Neuroradiol, Basel, Switzerland
关键词
Aneurysm; Aneurysm multiplicity; Subarachnoid hemorrhage; UNRUPTURED INTRACRANIAL ANEURYSMS; RISK-FACTORS; REGISTRY; AGE; SMOKING; RUPTURE; DISEASE; GENDER; SAHIT; SIZE;
D O I
10.1016/j.wneu.2017.12.046
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: The literature on multiple intracranial aneurysms (MIA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) focuses largely on risk factor analysis and consists essentially of retrospective cohort studies of limited sample size, or studies in populations outside Europe and North America. The purpose of this cohort study was to identify predictors for aneurysm multiplicity and to investigate the anatomic distribution of MIA in a representative Western cohort of patients with aSAH. METHODS: The Swiss Study of Subarachnoid Hemorrhage (SOS) database includes anonymized data from all tertiary neurovascular facilities in Switzerland. The dataset for 2009-2014 was used to compare characteristics of patients with aSAH and MIA and those with a single intracranial aneurysm (SIA) by means of descriptive and multivariate regression analysis. RESULTS: Among 1689 unselected patientswith aSAH, 467 had MIA (prevalence, 27.6%). The location of the ruptured index aneurysmwas correlated with the probability of finding bystander aneurysms and predicted their likely anatomic distribution. Patients with a ruptured basilar artery aneurysm (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.30-3.44) or a ruptured middle cerebral artery aneurysm (OR, 1.86; 95% CI, 1.35-2.55) were at the greatest risk for having MIA. Larger size of the index aneurysm (OR per 1 mm, 1.03; 95% CI, 1.01-1.06) was also positively correlated with aneurysm multiplicity. Males were less likely than females to haveMIA (OR, 0.79; 95% CI, 0.61-1.01). CONCLUSIONS: In patients with aSAH, the location of the ruptured index aneurysm is correlated with the probability of finding bystander aneurysms, and is predictive of the sites at which bystander aneurysms are most likely to be found.
引用
收藏
页码:E192 / E198
页数:7
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