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KMID : 1001920160590010011
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Journal of Korean Neurosurgical Society
2016 Volume.59 No. 1 p.11 ~ p.16
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Natural History of Unruptured Intracranial Aneurysms : A Retrospective Single Center Analysis
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Byoun Hyoung-Soo
Huh Won
Oh Chang-Wan
Bang Jae-Seung
Hwang Gyo-Jun
Kwon O-Ki
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Abstract
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Objective: We conducted a retrospective cohort study to elucidate the natural course of unruptured intracranial aneurysms (UIAs) at a single institution.
Methods: 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.
Results: 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%.
Conclusion: 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.
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KEYWORD
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Natural history, Intracranial aneurysms, Rupture rate, Risk factors
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