Aneurysm Characteristics Associated with the Rupture Risk of Intracranial Aneurysms: A Self-Controlled Study.
Aneurysm Characteristics Associated with the Rupture Risk of Intracranial Aneurysms: A Self-Controlled Study.
复制标题
DOI：
10.1371/journal.pone.0142330
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Liu A
中科院分区：
文献类型：
--
作者：
Kang H;Ji W;Qian Z;Li Y;Jiang C;Wu Z;Wen X;Xu W;Liu A
本研究通过比较同一患者不同位置的两个动脉瘤之间的差异，根据动脉瘤的特征分析颅内动脉瘤（IA）的破裂风险。我们利用这种自我对照模型排除所有人口统计学因素的潜在干扰，以研究与IA破裂相关的危险因素。2011年1月至2015年4月期间，共有103例患者被诊断为IA，并入组本研究。所有入组患者均接受了两次IA。一个IA（病例）破裂，另一个（对照）未破裂。动脉瘤特征，包括是否存在子囊、动脉瘤颈、载瘤动脉直径、最大动脉瘤高度、最大动脉瘤宽度、位置、纵横比（AR，最大垂直高度/平均瘤颈直径），尺寸比（SR，最大动脉瘤高度/平均载瘤直径）和宽高比（WH比，最大动脉瘤宽度/最大动脉瘤高度），以评价每例患者内两个IA的破裂风险，并识别与IA破裂相关的独立风险因素。多因素、条件、后向、逐步Logistic回归分析，以确定与IA破裂相关的独立危险因素。多变量分析确定了子囊的存在（比值比[OR]，13.80; 95%置信区间[CI]，1.65-115.87），最大动脉瘤高度≥7 mm（OR，4.80; 95% CI，1.21-18.98），位于后交通动脉（PCOM）或前交通动脉（ACOM; OR，3.09; 95%CI，1.34-7.11）和SR（OR，2.13; 95%CI，1.16-3.91）作为与IA破裂显著相关的因素。子囊的存在、动脉瘤最大高度、PCOM或ACOM位置和未破裂IA的SR（>1.5±0.7）与IA破裂显著相关。
This study analyzed the rupture risk of intracranial aneurysms (IAs) according to aneurysm characteristics by comparing the differences between two aneurysms in different locations within the same patient. We utilized this self-controlled model to exclude potential interference from all demographic factors to study the risk factors related to IA rupture. A total of 103 patients were diagnosed with IAs between January 2011 and April 2015 and were enrolled in this study. All enrolled patients had two IAs. One IA (the case) was ruptured, and the other (the control) was unruptured. Aneurysm characteristics, including the presence of a daughter sac, the aneurysm neck, the parent artery diameter, the maximum aneurysm height, the maximum aneurysm width, the location, the aspect ratio (AR, maximum perpendicular height/average neck diameter), the size ratio (SR, maximum aneurysm height/average parent diameter) and the width/height ratio (WH ratio, maximum aneurysm width/maximum aneurysm height), were collected and analyzed to evaluate the rupture risks of the two IAs within each patient and to identify the independent risk factors associated with IA rupture. Multivariate, conditional, backward, stepwise logistic regression analysis was performed to identify the independent risk factors associated with IA rupture. The multivariate analysis identified the presence of a daughter sac (odds ratio [OR], 13.80; 95% confidence interval [CI], 1.65–115.87), a maximum aneurysm height ≥7 mm (OR, 4.80; 95% CI, 1.21–18.98), location on the posterior communicating artery (PCOM) or anterior communicating artery (ACOM; OR, 3.09; 95% CI, 1.34–7.11) and SR (OR, 2.13; 95% CI, 1.16–3.91) as factors that were significantly associated with IA rupture. The presence of a daughter sac, the maximum aneurysm height, PCOM or ACOM locations and SR (>1.5±0.7) of unruptured IAs were significantly associated with IA rupture.