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Original research
Location specific rupture risk of intracranial aneurysms: case of ophthalmic aneurysms
  1. Pierre-Marie Chiaroni1,
  2. Xavier Guerra1,2,
  3. Jonathan Cortese3,
  4. Julien Burel4,
  5. Thomas Courret5,
  6. Pacome Constant dit Beaufils6,
  7. Thibault Agripnidis7,
  8. Ian Leonard-Lorant8,
  9. Cédric Fauché9,
  10. Nourou Dine Adeniran Bankole10,
  11. Géraud Forestier11,
  12. Vincent L'allinec12,
  13. Peter B Sporns13,14,
  14. Gaelle Gueton15,
  15. Nico Lorena15,
  16. Marios-Nikos Psychogios13,
  17. Jean-Baptiste Girot12,
  18. Aymeric Rouchaud11,16,
  19. Kevin Janot10,
  20. Nicolas Raynaud9,
  21. Raoul Pop8,
  22. Jean-Francois Hak7,
  23. Basile Kerleroux2,
  24. Romain Bourcier6,
  25. Gaultier Marnat5,
  26. Chrysanthi Papagiannaki4,
  27. Nader-Antoine Sourour1,
  28. Frédéric Clarençon1,17,
  29. Eimad Shotar1,18
  30. JENI Research Collaboration
    1. 1Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France
    2. 2Sainte Anne Hospital, Paris, France
    3. 3Interventional Neuroradiology, Bicêtre Hospital, Le Kremlin-Bicêtre, France
    4. 4Radiology, Rouen University Hospital, Rouen, France
    5. 5Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
    6. 6Diagnostic and Interventional Neuroradiology Department, CHU Nantes, Nantes, France
    7. 7Department of Neuroradiology, APHM La Timone, Marseille, France
    8. 8Interventional Neuroradiology Department, Strasbourg University Hospital, Strasbourg, France
    9. 9Radiology, CHU Poitiers, Poitiers, France
    10. 10Neuroradiology, University Hospital of Tours, Tours, France
    11. 11Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
    12. 12Radiology Department, CHU Angers, Angers, France
    13. 13Department of Neuroradiology, University Hospital Basel, Basel, Switzerland
    14. 14Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
    15. 15Interventional Neuroradiology Department, Saint-Etienne University Hospital, Saint-Etienne, France
    16. 16University of Limoges, CNRS, XLIM, UMR 7252, Limoges, France
    17. 17Sorbonne University, Paris, France
    18. 18INSERM, CNRS, Vision Institute, Sorbonne University, Paris, France
    1. Correspondence to Dr Eimad Shotar, Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris 75013, France; eimad.shotar{at}


    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.

    • Aneurysm

    Data availability statement

    Data are available upon reasonable request.

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    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.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.