Miyazawa Nobuhiko, Akiyama Iwao, Yamagata Zentaro
Department of Neurosurgery, Kofu Neurosurgical Hospital, Yamanashi, Japan.
Neurosurgery. 2006 Jun;58(6):1047-53; discussion 1047-53. doi: 10.1227/01.NEU.0000217366.02567.D2.
The independent risk factors for aneurysm growth were retrospectively investigated in 130 patients with unruptured aneurysms who were followed up by 0.5-T serial magnetic resonance angiography with stereoscopic images.
Age, sex, site of aneurysm, size of aneurysm, multiplicity of aneurysms, type of circle of Willis, length of follow-up period, cerebrovascular event, hypertension, diabetes, hyperlipidemia, smoking habit, and family history of subarachnoid hemorrhage were investigated using multiple logistic analysis.
Fourteen patients (16 aneurysms) among the 130 patients (159 aneurysms) showed aneurysm growth (10.8%) during follow-up of 10 to 69 months (mean 29.3 +/- 10.5 mo). Multiple logistic analysis disclosed that location on the middle cerebral artery (odds ratio [OR] 0.08, P < 0.01), multiplicity of aneurysms (OR 68.5, P < 0.01), aneurysm size of 5 mm or larger (OR 1.17, P = 0.05), and family history of subarachnoid hemorrhage (OR 10.9, P < 0.01) were independent risk factors.
Location on the middle cerebral artery, multiplicity, aneurysm size of 5 mm or larger, and family history of subarachnoid hemorrhage are independent risk factors for aneurysm growth. These results may help to determine the treatment choice for unruptured aneurysms.
回顾性研究130例未破裂动脉瘤患者的动脉瘤生长独立危险因素,这些患者采用0.5-T系列磁共振血管造影立体成像进行随访。
采用多因素logistic分析研究年龄、性别、动脉瘤部位、动脉瘤大小、动脉瘤数量、Willis环类型、随访时间、脑血管事件、高血压、糖尿病、高脂血症、吸烟习惯和蛛网膜下腔出血家族史。
130例患者(159个动脉瘤)中有14例患者(16个动脉瘤)在10至69个月(平均29.3±10.5个月)的随访期间出现动脉瘤生长(10.8%)。多因素logistic分析显示,大脑中动脉部位(比值比[OR]0.08,P<0.01)、动脉瘤数量(OR 68.5,P<0.01)、动脉瘤大小≥5 mm(OR 1.17,P = 0.05)和蛛网膜下腔出血家族史(OR 10.9,P<0.01)是独立危险因素。
大脑中动脉部位、动脉瘤数量、动脉瘤大小≥5 mm和蛛网膜下腔出血家族史是动脉瘤生长的独立危险因素。这些结果可能有助于确定未破裂动脉瘤的治疗选择。