Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland.
Department of Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland.
Sci Rep. 2021 Dec 9;11(1):23729. doi: 10.1038/s41598-021-02963-z.
The prevalence of unruptured intracranial aneurysms (UIAs) is around 2-3% in the general population. We hypothesized that the prevalence of small UIAs is higher among 50 to 60-year-old female smokers, since the incidence of aneurysmal subarachnoid hemorrhage (aSAH) is exceptionally high in 60 to 70-year-old female smokers. Ethics approval for this pilot study of 50 women was obtained from the hospital ethics committee. In order to minimize recruitment bias, preliminary invitation letters were sent to 50 to 60-year-old women who were known to be active smokers. Those interested in participating were further informed about the study rationale and protocol. Following written consent, participants filled a detailed questionnaire and underwent computed tomography angiography (CTA) analysis. All abnormalities were recorded. Of the 158 preliminary invitation letters, 70 potential participants initially replied. Of these, 50 returned questionnaires and written consents, 43 of which underwent CTA analysis. Most (39; 91%) were postmenopausal, and 9 (21%) were hypertensive. Two reported a family history (≥ 1 first-degree members) of intracranial aneurysms. UIAs (maximum sizes of 2, 2, 3, 3 and 7 mm) were found in five (12%) female smokers. One woman was operated on, and the remaining four were treated with non-invasive preventive actions (smoking cessation and follow-ups). Small UIAs, which may be best suited for non-invasive preventive actions, may be relatively common in 50 to 60-year-old female smokers. Whether this kind of targeted screening leads to improved health in female smokers requires further investigation.
颅内未破裂动脉瘤（UIAs）在普通人群中的患病率约为 2-3%。我们假设，50 至 60 岁的女性吸烟者中小 UIAs 的患病率更高，因为 60 至 70 岁的女性吸烟者中动脉瘤性蛛网膜下腔出血（aSAH）的发病率异常高。这项针对 50 名女性的试点研究获得了医院伦理委员会的批准。为了最大程度地减少招募偏倚，初步邀请信寄给了已知是活跃吸烟者的 50 至 60 岁女性。对参加研究感兴趣的人进一步了解了研究的理由和方案。在书面同意后，参与者填写了详细的问卷并接受了计算机断层血管造影术（CTA）分析。所有异常情况均被记录。在 158 封初步邀请信中，有 70 名潜在参与者最初回复。其中，有 50 人返回了问卷和书面同意书，其中 43 人接受了 CTA 分析。大多数（39 人；91%）处于绝经后，9 人（21%）患有高血压。有两人报告有颅内动脉瘤（≥ 1 位一级亲属）家族史。在五名（12%）女性吸烟者中发现了 UIAs（最大尺寸为 2、2、3、3 和 7 毫米）。一名女性接受了手术，其余四名女性接受了非侵入性预防措施（戒烟和随访）。在 50 至 60 岁的女性吸烟者中，可能最适合非侵入性预防措施的小 UIAs 可能相对常见。这种有针对性的筛查是否能改善女性吸烟者的健康状况，还需要进一步研究。
