Risk of rupture of small anterior communicating artery aneurysms is similar to posterior circulation aneurysms

Bijlenga, Philippe and Ebeling, Christian and Jaegersberg, Max and Summers, Paul and Rogers, Alister and Waterworth, Alan and Iavindrasana, Jimison and Macho, Juan and Pereira, Vitor Mendes and Bukovics, Peter and Vivas, Elio and Sturkenboom, Miriam C. J. M. and Wright, Jessica and Friedrich, Christoph M. and Frangi, Alejandro and Byrne, James and Schaller, Karl and Rufenacht, Daniel. (2013) Risk of rupture of small anterior communicating artery aneurysms is similar to posterior circulation aneurysms. Stroke : a journal of cerebral circulation : journal of the American Heart Association, Vol. 44, H. 11. pp. 3018-3026.

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Official URL: http://edoc.unibas.ch/dok/A6205580

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According to the International Study of Unruptured Intracranial Aneurysms (ISUIA), anterior circulation (AC) aneurysms of >7 mm in diameter have a minimal risk of rupture. It is general experience, however, that anterior communicating artery (AcoA) aneurysms are frequent and mostly rupture at >7 mm. The aim of the study was to assess whether AcoA aneurysms behave differently from other AC aneurysms.; Information about 932 patients newly diagnosed with intracranial aneurysms between November 1, 2006, and March 31, 2012, including aneurysm status at diagnosis, its location, size, and risk factors, was collected during the multicenter @neurIST project. For each location or location and size subgroup, the odds ratio (OR) of aneurysms being ruptured at diagnosis was calculated.; The OR for aneurysms to be discovered ruptured was significantly higher for AcoA (OR, 3.5 [95% confidence interval, 2.6-4.5]) and posterior circulation (OR, 2.6 [95% confidence interval, 2.1-3.3]) than for AC excluding AcoA (OR, 0.5 [95% confidence interval, 0.4-0.6]). Although a threshold of 7 mm has been suggested by ISUIA as a threshold for aggressive treatment, AcoA aneurysms >7 mm were more frequently found ruptured (OR, 2.0 [95% confidence interval, 1.3-3.0]) than AC aneurysms of 7 to 12 mm diameter as defined in ISUIA.; We found that AC aneurysms are not a homogenous group. Aneurysms between 4 and 7 mm located in AcoA or distal anterior cerebral artery present similar rupture odds to posterior circulation aneurysms. Intervention should be recommended for this high-risk lesion group.
Faculties and Departments:08 Cross-disciplinary Subjects > Ethik > Institut für Bio- und Medizinethik > Bio- und Medizinethik (Elger)
03 Faculty of Medicine > Departement Public Health > Ethik in der Medizin > Bio- und Medizinethik (Elger)
UniBasel Contributors:Elger, Bernice Simone
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:American Heart Association
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:31 Jan 2014 09:50
Deposited On:31 Jan 2014 09:50

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