Lu Hai-Tao, Tan Hua-Qiao, Gu Bin-Xian, Li Ming-Hua
Institute of Interventional and Diagnostic Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai 200233, China.
Clin Neurol Neurosurg. 2013 Jun;115(6):690-4. doi: 10.1016/j.clineuro.2012.08.011. Epub 2012 Aug 22.
The presence of predicting the rupture risk of intracranial aneurysms has recently generated considerable controversy. We retrospectively investigated the risk factors for multiple intracranial aneurysms related to rupture.
Between July 2007 and July 2011, 134 patients with 294 aneurysms were identified after review. Every patient had two or more aneurysms. Univariate and multivariate logistic regression models were used to analyze the risk factors for multiple intracranial aneurysms with age, gender, site and size.
134 patients were divided into three groups according to patient age category (<45, 45-65, >65 years of age). The incidence of aneurysms ruptured in the second group was significantly higher. Three groups showed significant difference (P=0.001 versus >65 years of age). Thirteen of 35 AComA aneurysms were ruptured, accounting for 26% of all ruptured aneurysms, and the rate of rupture at AComA aneurysms in patients was 37.1%. The rate of aneurysm rupture in the AComA was significantly higher than that in other sites (P=0.001). In all 294 aneurysms, 88.1% of the aneurysms were 5mm or less, of which 58.2% were less than 3mm. In the ruptured aneurysms, 68% were 5mm or less.
Our study reveals the pattern of ruptured multiple intracranial aneurysms, in terms of age, size and location of aneurysms. Age, size, and site of aneurysm should be considered in the decision whether to treat an unruptured aneurysm or not. Especially, in cases of multiple aneurysm, the AComA aneurysm is most prone to hemorrhage.
颅内动脉瘤破裂风险预测因素的存在最近引发了相当大的争议。我们回顾性研究了与破裂相关的多发性颅内动脉瘤的危险因素。
在2007年7月至2011年7月期间，经复查确定了134例患有294个动脉瘤的患者。每位患者有两个或更多动脉瘤。采用单因素和多因素逻辑回归模型，分析年龄、性别、部位和大小等因素对多发性颅内动脉瘤的影响。
134例患者根据年龄分为三组（<45岁、45 - 65岁、>65岁）。第二组动脉瘤破裂的发生率显著更高。三组之间存在显著差异（与>65岁组相比，P = 0.001）。35个前交通动脉瘤中有13个破裂，占所有破裂动脉瘤的26%，患者前交通动脉瘤的破裂率为37.1%。前交通动脉瘤的破裂率显著高于其他部位（P = 0.001）。在所有294个动脉瘤中，88.1%的动脉瘤直径为5mm或更小，其中58.2%小于3mm。在破裂的动脉瘤中，68%直径为5mm或更小。
我们的研究揭示了多发性颅内动脉瘤破裂在年龄、大小和动脉瘤位置方面的模式。在决定是否治疗未破裂动脉瘤时，应考虑动脉瘤的年龄、大小和部位。特别是在多发性动脉瘤的情况下，前交通动脉瘤最容易出血。
