Predictors of Atherosclerotic Change in Unruptured Intracranial Aneurysms and Parent Arteries During Clipping.

OBJECTIVES

To identify predictors of atherosclerotic change in aneurysms and parent arteries, and to retrospectively analyze outcomes from clipped aneurysms that showed atherosclerotic changes.

METHODS

Between May 2017 and April 2018, we collected a total of 151 clipping cases and reviewed records of operation videos to classify atherosclerosis by location (dome, neck of aneurysm, or parent artery). To identify predictors of atherosclerotic change in aneurysms, we analyzed baseline demographic characteristics, preoperative images, and Framingham Risk Scores (FRS). We also analyzed incomplete clipping cases according to atherosclerosis presence and location.

RESULT

This study cohort included 110 women (mean age, 59.3 ± 7.1 years) and 41 men (mean age, 55.9 ± 9.6 years). Atherosclerotic change was seen in 77 cases. FRS, diabetes mellitus, and aneurysm size were identified as independent risk factors for atherosclerotic change in multivariate logistic regression analysis. There were 11 incomplete clipping cases (7.2%). Among the 30 cases with atherosclerotic change in the neck were 10 cases of incomplete clipping (P < 0.001).

CONCLUSIONS

FRS, diabetes mellitus, and aneurysm size as predictors of atherosclerosis in patients undergoing aneurysm surgery can help guide surgical decisions and performance.