PT - JOURNAL ARTICLE AU - Heit, Jeremy J AU - Gonzalez, R Gilberto AU - Sabbag, David AU - Brouwers, H Bart AU - Ordonez Rubiano, Edgar Gerardo AU - Schaefer, Pamela W AU - Hirsch, Joshua A AU - Romero, Javier M TI - Detection and characterization of intracranial aneurysms: a 10-year multidetector CT angiography experience in a large center AID - 10.1136/neurintsurg-2015-012082 DP - 2016 Nov 01 TA - Journal of NeuroInterventional Surgery PG - 1168--1172 VI - 8 IP - 11 4099 - http://jnis.bmj.com/content/8/11/1168.short 4100 - http://jnis.bmj.com/content/8/11/1168.full SO - J NeuroIntervent Surg2016 Nov 01; 8 AB - 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.