Dharmadhikari Sushrut, Atchaneeyasakul Kunakorn, Ambekar Sudheer, Saini Vasu, Haussen Diogo C, Yavagal Dileep
Department of Neurology, University of Miami - Miller School of Medicine, Miami, Florida, USA.
Department of Neurosurgery, University of Miami - Miller School of Medicine, Miami, Florida, USA.
Interv Neurol. 2020 Jan;8(2-6):109-115. doi: 10.1159/000496701. Epub 2019 Feb 15.
The prevalence of unruptured intracranial aneurysms (UIAs) increases rapidly in aging women compared with younger women. The impact of menopausal age on UIAs and treatment outcomes with endovascular therapy has not been well studied. We hypothesized that premenopausal age may have a protective effect on presentation size and treatment outcomes.
To evaluate the association of menopause with UIA size and outcome with endovascular therapy.
Retrospective analysis of consecutive female patients with UIAs treated with endovascular therapy at our academic tertiary care center. UIA characteristics, complications, and outcomes were recorded and compared.
117 patients were included: 23 patients in the premenopausal age (PRM) group and 94 in the postmenopausal age (POM) group. 93.6% of all aneurysms in the PRM group were in the internal carotid artery (ICA) segments ( < 0.05). Hence only ICA segment aneurysms were further studied. A total of 21 patients in the PRM group and 60 in the POM group were found to have ICA segment aneurysms. Baseline characteristics were similar between the 2 groups. The mean size of the aneurysms in the PRM group was 8.6 ± 3.9 versus 10.8 ± 5.6 mm in the POM group ( = 0.055). There was a trend to higher aneurysm neck size seen in the POM group (4.7 ± 2.5 vs. 3.7 ± 1.7 mm; = 0.07). The number of aneurysm lobes was higher in the PRM group (1.23 ± 0.54 vs. 1.07 ± 0.31; = 0.18). In multivariate analysis, the PRM group had a significantly higher number of UIA lobes. Complications and endovascular therapy outcomes were similar between the 2 groups.
A trend to increased UIA maximal diameter and neck size was seen in the POM group compared to the PRM group. The PRM group had a significantly higher number of UIA lobes. Larger prospective trials are needed to confirm these findings.
与年轻女性相比，未破裂颅内动脉瘤（UIAs）在老年女性中的患病率迅速上升。绝经年龄对UIAs及血管内治疗效果的影响尚未得到充分研究。我们推测绝经前年龄可能对动脉瘤的表现大小及治疗效果具有保护作用。
评估绝经与UIA大小及血管内治疗效果之间的关联。
对在我们学术性三级医疗中心接受血管内治疗的连续女性UIA患者进行回顾性分析。记录并比较UIA的特征、并发症及治疗效果。
纳入117例患者：绝经前年龄（PRM）组23例患者，绝经后年龄（POM）组94例患者。PRM组所有动脉瘤的93.6%位于颈内动脉（ICA）段（<0.05）。因此仅对ICA段动脉瘤进行进一步研究。PRM组共有21例患者、POM组共有60例患者被发现患有ICA段动脉瘤。两组的基线特征相似。PRM组动脉瘤的平均大小为8.6±3.9mm，而POM组为10.8±5.6mm（=0.055）。POM组动脉瘤颈部大小有增大趋势（4.7±2.5对3.7±1.7mm；=0.07）。PRM组动脉瘤叶的数量更多（1.23±0.54对1.07±0.31；=0.18）。在多变量分析中，PRM组UIA叶的数量显著更多。两组的并发症及血管内治疗效果相似。
与PRM组相比，POM组UIA最大直径及颈部大小有增大趋势。PRM组UIA叶的数量显著更多。需要更大规模的前瞻性试验来证实这些发现。
