Figueredo Luisa F, Camila Pedraza-Ciro María, Sebastian Lopez-McCormick Juan, Javier Rueda-Esteban Roberto, Armando Mejía-Cordovez Juan
School of Medicine, Universidad de los Andes, Bogotá, Colombia.
School of Medicine, Universidad El Bosque, Bogotá, Colombia.
World Neurosurg X. 2019 May 21;4:100038. doi: 10.1016/j.wnsx.2019.100038. eCollection 2019 Oct.
Previous studies have shown low rupture rates for small aneurysms (<10 mm), suggesting that the risk of treatment could exceed the benefits. However, evidence has changed, showing crescent rates of aneurysmal subarachnoid hemorrhage (aSAH) associated with small aneurysms. We report trends in size, localization, clinical characteristics, and outcomes of intracranial aneurysms (IAs).
In this retrospective study, a total of 200 clinical histories of patients diagnosed with IAs over an 8-year period were analyzed. Variables considered included age, sex, tobacco consumption, morphological characteristics of the aneurysm, complications, vasospasm, and mortality. Qualitative variables were assessed by measurements of absolute and relative frequency. Smoking behavior, aneurysm size, and aneurysm rupture (AR) were compared using 1-way analysis of variance. Categorical variables were analyzed using Pearson's χ test.
The average age at presentation was 58 years. The average size of ruptured aneurysms in the general group was 2.5-7.5 mm, and AR was most common in women (76%) and in patients age 50-60 years (33%). The rate of vasospasm was 19%, and mortality was 37%. Smokers composed 32% of the cohort. Heavy smokers had a 57% rate of aSAH, with an average size of rupture of 5 mm. The most common location of aneurysms and AR was the AComA (33%).
Our results suggest increasing AR rates in aneurysms smaller than 10 mm. This trend is seen especially in individuals with heavy tobacco consumption and in women of perimenopausal age. Our findings show a tendency of AR in accordance with previous results and are expected to serve as basis for further research on aneurysm management.
以往研究表明小型动脉瘤（<10 mm）的破裂率较低，这表明治疗风险可能超过益处。然而，现有证据已发生变化，显示小型动脉瘤相关的动脉瘤性蛛网膜下腔出血（aSAH）发生率呈上升趋势。我们报告了颅内动脉瘤（IA）的大小、位置、临床特征及转归的趋势。
在这项回顾性研究中，分析了8年间共200例诊断为IA患者的临床病史。所考虑的变量包括年龄、性别、吸烟情况、动脉瘤的形态特征、并发症、血管痉挛和死亡率。定性变量通过绝对频率和相对频率测量进行评估。吸烟行为、动脉瘤大小和动脉瘤破裂（AR）采用单因素方差分析进行比较。分类变量采用Pearson卡方检验进行分析。
就诊时的平均年龄为58岁。总体组中破裂动脉瘤的平均大小为2.5 - 7.5 mm，AR在女性（76%）和50 - 60岁患者（33%）中最为常见。血管痉挛发生率为19%，死亡率为37%。吸烟者占队列的32%。重度吸烟者aSAH发生率为57%，破裂平均大小为5 mm。动脉瘤及AR最常见的位置是前交通动脉（AComA，33%）。
我们的结果提示小于10 mm的动脉瘤AR发生率增加。这种趋势在重度吸烟者和围绝经期女性中尤为明显。我们的研究结果显示AR的一种趋势与先前结果一致，有望为进一步研究动脉瘤的管理提供依据。
