Ishibashi Toshihiro, Murayama Yuichi, Urashima Mitsuyoshi, Saguchi Takayuki, Ebara Masaki, Arakawa Hideki, Irie Koreaki, Takao Hiroyuki, Abe Toshiaki
Stroke. 2009 Jan;40(1):313-6. doi: 10.1161/STROKEAHA.108.521674. Epub 2008 Oct 9.
Backgrounds and Purpose- The authors evaluated the incidence of rupture of unruptured intracranial saccular aneurysm during observation.
Between January 2003 and December 2006, a total of 419 patients with 529 unruptured intracranial saccular aneurysms were observed without treatment. The mean follow-up duration was 905.3 days. Aneurysm size was measured by 3-dimensional CT angiography. Clinical and 3-dimensional CT angiography follow-up were obtained every 6 months.
Nineteen aneurysms ruptured during observation resulting in a 1.4% rupture rate per year. A history of subarachnoid hemorrhage (hazard ratio, 7.3; 95% CI, 2.5 to 21.2), posterior circulation aneurysm (hazard ratio, 2.9; 95% CI, 1.1 to 8), and large size were significant independent predictors for aneurysm rupture.
Size, history of subarachnoid hemorrhage, and posterior circulation aneurysms were significant risk factors for prediction of rupture of unruptured intracranial saccular aneurysms.
背景与目的——作者评估了未破裂颅内囊状动脉瘤在观察期间的破裂发生率。
在2003年1月至2006年12月期间，共观察了419例患有529个未破裂颅内囊状动脉瘤的患者，未进行治疗。平均随访时间为905.3天。通过三维CT血管造影测量动脉瘤大小。每6个月进行临床和三维CT血管造影随访。
19个动脉瘤在观察期间破裂，每年破裂率为1.4%。蛛网膜下腔出血病史（风险比，7.3；95%可信区间，2.5至21.2）、后循环动脉瘤（风险比，2.9；95%可信区间，1.1至8）和大尺寸是动脉瘤破裂的显著独立预测因素。
大小、蛛网膜下腔出血病史和后循环动脉瘤是预测未破裂颅内囊状动脉瘤破裂的重要危险因素。
