Background Aneurysm location is a key element in predicting the rupture risk of an intracranial aneurysm. A common impression suggests that pure ophthalmic aneurysms are under-represented in ruptured intracranial aneurysms (RIAs). The purpose of this study was to specifically evaluate the risk of rupture of ophthalmic aneurysms compared with other aneurysm locations.
Methods This multicenter study compared the frequency of ophthalmic aneurysms in a prospective cohort of RIAs admitted to 13 neuroradiology centers between January 2021 and March 2021, with a retrospective cohort of patients with unruptured intracranial aneurysms (UIAs) who underwent cerebral angiography at the same neuroradiology centers during the same time period.
Results 604 intracranial aneurysms were included in this study (355 UIAs and 249 RIAs; mean age 57 years (IQR 49–65); women 309/486, 64%). Mean aneurysm size was 6.0 mm (5.3 mm for UIAs, 7.0 mm for RIAs; P<0.0001). Aneurysm shape was irregular for 37% UIAs and 73% RIAs (P<0.0001). Ophthalmic aneurysms frequency was 14.9% of UIAs (second most common aneurysm location) and 1.2% of RIAs (second least common aneurysm location; OR 0.07 (95% CI 0.02 to 0.23), P<0.0001).
Conclusions Ophthalmic aneurysms seem to have a low risk of rupture compared with other intracranial aneurysm locations. This calls for a re-evaluation of the benefit–risk balance when considering preventive treatment for ophthalmic aneurysms.
Data availability statement
Data are available upon reasonable request.
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Collaborators JENI Research Collaboration: Dr Curado Adelya, Dr Lefebvre Margaux, Dr Papaxanthos Jean, Pr Mounayer Charbel, Dr Saleme Suzana, Dr Nguyen-Kim Dan Linh, Dr Boulouis Grégoire, Dr Ifergan Héloïse, Dr Bala Fouzi, Dr Bibi Richard, Dr Barrot Valère, Pr Herbreteau Denis, Dr Velasco Stéphane, Dr Allard Julien, Dr Lenck Stéphanie, and Dr Premat Kévin.
Contributors P-MC: conception and design of the work, analysis and interpretation of data for the work, and drafting and revising the manuscript. JC: statistical analysis and revising the manuscript. XG, JB, TC, PCdB, TA, IL-L, CF, NDB, GF, VL’a, PBS, GG, NL, M-NP, J-BG, AR, KJ, NR, RP, J-FH, BK, RB, GM, CP: acquisition of data for work and revising the manuscript. N-AS: interpretation of data for the work and critically revising the manuscript. FC: conception and design of the work, interpretation of data for the work, and critically revising the manuscript. ES: conception and design of the work, interpretation of data for the work, and drafting and revising critically the manuscript. P-MC is acting as guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.
Competing interests FC is a consultant for Medtronic, Balt Extrusion, Penumbra, Microvention, and Stryker; board member of Artedrone, and has stock options with Intradys and Collavidence. GM is a consultant for Stryker Neurovascular, Balt, Microvention Europe, and Sim and Cure, and has done paid lectures for Medtronic, Phenox, Johnson & Johnson, and Bracco. KJ is a consultant for Balt. AR is a consultant for Balt, Medtronic, Microvention, and Stryker. N-AS is a consultant for Balt, Medtronic Extrusion, and Microvention.
Provenance and peer review Not commissioned; externally peer reviewed.
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