Natural History of Unruptured Intracranial Aneurysms : A Retrospective Single Center Analysis.
Natural History of Unruptured Intracranial Aneurysms : A Retrospective Single Center Analysis.
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DOI：
10.3340/jkns.2016.59.1.11
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发表时间：
2016-01
影响因子：
1.6
通讯作者：
Kwon OK
中科院分区：
文献类型：
--
作者：
Byoun HS;Huh W;Oh CW;Bang JS;Hwang G;Kwon OK
我们进行了一项回顾性队列研究，以阐明在单一机构中未破裂颅内动脉瘤（UIAs）的自然病程。对2000年3月至2008年5月在我院诊断为UIA的患者资料进行回顾性分析。计算累积和年动脉瘤破裂率。此外，确定了与动脉瘤破裂相关的危险因素。1006例患者中有1339个动脉瘤符合纳入标准。在随访期间，685个动脉瘤在破裂前通过开放手术或血管内手术进行了治疗。654个uia被发现，但在随访期间没有得到修复。UIA的平均尺寸为4.5±3.2 mm，最大尺寸<7 mm的占86.5%。在这些uia中，18例在第0天破裂，中位时间为1.6年（范围：27天至9.8年）。9年随访期间的年破裂风险为1.00%。多因素Cox比例风险分析显示，动脉瘤大小和蛛网膜下腔出血（SAH）史是动脉瘤破裂的有统计学意义的危险因素。对于没有SAH病史的小于7mm的动脉瘤，年破裂风险为0.79%。在我们的研究中，在没有SAH病史的情况下，小于7 mm的uia的年破裂风险高于西方人群，但与日本人群相似。
We conducted a retrospective cohort study to elucidate the natural course of unruptured intracranial aneurysms (UIAs) at a single institution. Data from patients diagnosed with UIA from March 2000 to May 2008 at our hospital were subjected to a retrospective analysis. The cumulative and annual aneurysm rupture rates were calculated. Additionally, risk factors associated with aneurysmal rupture were identified. A total of 1339 aneurysms in 1006 patients met the inclusion criteria. During the follow-up period, 685 aneurysms were treated before rupture via either an open surgical or endovascular procedure. Six hundred fifty-four UIAs were identified and not repaired during the follow-up period. The mean UIA size was 4.5±3.2 mm, and 86.5% of the total UIAs had a largest dimension <7 mm. Among these UIAs, 18 ruptured at a median of 1.6 years (range : 27 days to 9.8 years) after day 0. The annual rupture risk during a 9-year follow-up was 1.00%. A multivariate Cox proportional hazards analysis revealed that the aneurysm size and a history of subarachnoid hemorrhage (SAH) were statistically significant risk factors for rupture. For an aneurysms smaller than 7 mm in the absence of a history of SAH, the annual rupture risk was 0.79%. In our study, the annual rupture risk for UIAs smaller than 7 mm in the absence of a history of SAH was higher than that of Western populations but similar to that of the Japanese population.