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Original research
Detection and characterization of intracranial aneurysms: a 10-year multidetector CT angiography experience in a large center
  1. Jeremy J Heit1,
  2. R Gilberto Gonzalez2,
  3. David Sabbag3,
  4. H Bart Brouwers4,
  5. Edgar Gerardo Ordonez Rubiano5,
  6. Pamela W Schaefer2,
  7. Joshua A Hirsch6,
  8. Javier M Romero2
  1. 1Interventional Neuroradiology Division, Department of Radiology, Stanford University Hospital, Stanford, California, USA
  2. 2Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  4. 4Departments of Neurosurgery and Radiology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
  5. 5Department of Neurosurgery, Hospital Infantil Universitario de San Jose, Bogota, Bogota, Columbia
  6. 6Neurointerventional Radiology Division, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Jeremy J Heit, Interventional Neuroradiology Division, Department of Radiology, Stanford University, 300 Pasteur Drive, Room S-047, Stanford, CA 94305, USA; jheit{at}stanford.edu

Abstract

Background CT angiography (CTA) is increasingly used for the detection, characterization, and follow-up of intracranial aneurysms. A lower threshold to request a CT angiogram may render a patient population that differs from previous studies primarily evaluated with conventional angiography. Our objective was to broaden our knowledge of the factors associated with aneurysm rupture and patient mortality in this population.

Methods All CTA studies performed over a 10-year period at a large neurovascular referral center were reviewed for the presence of an intracranial aneurysm. Patient demographics, mortality, CTA indication, aneurysm location, size, and rupture status were recorded.

Results 2927 patients with aneurysms were identified among 29 003 CTAs. 17% of the aneurysms were ruptured at the time of imaging, 24% of aneurysms were incidentally identified, and multiple aneurysms were identified in 34% of patients. Aneurysms most commonly arose from the supraclinoid internal carotid artery (22%), the middle cerebral artery (18%), and the anterior communicating artery (13%). Male sex, age <50 years, aneurysms >6 mm, and aneurysms arising from the anterior communicating artery, posterior communicating artery, or the posterior circulation were independent predictors of aneurysm rupture. Independent mortality predictors included male sex, posterior circulation aneurysms, intraventricular hemorrhage, and intraparenchymal hemorrhage.

Conclusions These results indicate that aneurysms detected on CTA that arise from the anterior communicating artery, posterior communicating artery, or the posterior circulation, measure >6 mm in size, occur in men, and in patients aged <50 years are associated with rupture.

  • Aneurysm
  • CT Angiography
  • CT
  • Hemorrhage
  • Subarachnoid

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Footnotes

  • Twitter Follow Edgar Ordonez-Rubiano at @edgargo88

  • Contributors JJH, JMR, JAH, and RGG conceived and designed the research. JJH, DS, and EGOR acquired the data. JJH, JMR, JAH, RGG, and PWS analyzed and interpreted the data. JJH and JMR drafted the manuscript. JJH, JMR, JAH, RGG, and HBB made critical revisions to the manuscript. JJH, JMR, JAH, RGG, DS, EGOR, HBB, and PWS approved the final version of the manuscript.

  • Competing interests None declared.

  • Ethics approval Ethics approval was obtained from the Massachusetts General Hospital IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data available upon request and collaboration agreement.

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