Risk Factors for Intraprocedural Rupture in the Endovascular Treatment of Unruptured Intracranial Aneurysms: A Single-Center Experience with 1232 Procedures.

BACKGROUND

Intraprocedural rupture (IPR) is a rare complication that can occur during endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs). However, it universally leads to poor outcomes if not properly managed. In the present study, we sought to illuminate the risk factors for IPR during EVT of UIAs.

METHODS

The data from patients with UIAs who had undergone EVT in our center from January 2010 to March 2017 were retrospectively collected and reviewed. Univariate analysis and multivariate logistic analysis were performed to analyze the risk factors for IPR.

RESULTS

A total of 1232 patients with 1312 unruptured aneurysms were included in the present study. IPR occurred in 11 patients (0.9%). Univariate analysis showed that cardiac comorbidities, irregular morphology, and location at the anterior communicating artery (AcomA) were significantly associated with the development of IPR (P < 0.05). In addition, stent placement was related to a lower risk of IPR compared with no stent placement (P = 0.024). The multivariate analysis showed that cardiac comorbidities (odds ratio [OR], 6.320; P = 0.016), irregular morphology (OR, 9.562; P = 0.001), and location on the AcomA (OR, 6.971; P = 0.006) were independent risk factors for IPR.

CONCLUSIONS

The occurrence rate of IPR was relatively low. Cardiac comorbidities, irregular morphology, and location on the AcomA are independent risk factors for IPR. Stents and flow diverters are safe and feasible in treating UIA, with a significantly low risk of IPR.