Location specific rupture risk of intracranial aneurysms: case of ophthalmic aneurysms.

Aneurysm

Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
05 Oct 2023
Historique:
received: 15 08 2023
accepted: 13 09 2023
pubmed: 6 10 2023
medline: 6 10 2023
entrez: 5 10 2023
Statut: aheadofprint

Résumé

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. 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. 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). 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

pubmed: 37798103
pii: jnis-2023-020909
doi: 10.1136/jnis-2023-020909
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Curado Adelya (C)
Lefebvre Margaux (L)
Papaxanthos Jean (P)
Mounayer Charbel (M)
Saleme Suzana (S)
Nguyen-Kim Dan Linh (NK)
Boulouis Grégoire (B)
Ifergan Héloïse (I)
Bala Fouzi (B)
Bibi Richard (B)
Barrot Valère (B)
Herbreteau Denis (H)
Velasco Stéphane (V)
Allard Julien (A)
Lenck Stéphanie (L)
Premat Kévin (P)

Informations de copyright

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

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.

Auteurs

Pierre-Marie Chiaroni (PM)

Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France.

Xavier Guerra (X)

Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France.
Sainte Anne Hospital, Paris, France.

Jonathan Cortese (J)

Interventional Neuroradiology, Bicêtre Hospital, Le Kremlin-Bicêtre, France.

Julien Burel (J)

Radiology, Rouen University Hospital, Rouen, France.

Thomas Courret (T)

Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.

Pacome Constant Dit Beaufils (P)

Diagnostic and Interventional Neuroradiology Department, CHU Nantes, Nantes, France.

Thibault Agripnidis (T)

Department of Neuroradiology, APHM La Timone, Marseille, France.

Ian Leonard-Lorant (I)

Interventional Neuroradiology Department, Strasbourg University Hospital, Strasbourg, France.

Cédric Fauché (C)

Radiology, CHU Poitiers, Poitiers, France.

Nourou Dine Adeniran Bankole (NDA)

Neuroradiology, University Hospital of Tours, Tours, France.

Géraud Forestier (G)

Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France.

Vincent L'allinec (V)

Radiology Department, CHU Angers, Angers, France.

Peter B Sporns (PB)

Department of Neuroradiology, University Hospital Basel, Basel, Switzerland.
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Gaelle Gueton (G)

Interventional Neuroradiology Department, Saint-Etienne University Hospital, Saint-Etienne, France.

Nico Lorena (N)

Interventional Neuroradiology Department, Saint-Etienne University Hospital, Saint-Etienne, France.

Marios-Nikos Psychogios (MN)

Department of Neuroradiology, University Hospital Basel, Basel, Switzerland.

Jean-Baptiste Girot (JB)

Radiology Department, CHU Angers, Angers, France.

Aymeric Rouchaud (A)

Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France.
University of Limoges, CNRS, XLIM, UMR 7252, Limoges, France.

Kevin Janot (K)

Neuroradiology, University Hospital of Tours, Tours, France.

Nicolas Raynaud (N)

Radiology, CHU Poitiers, Poitiers, France.

Raoul Pop (R)

Interventional Neuroradiology Department, Strasbourg University Hospital, Strasbourg, France.

Jean-Francois Hak (JF)

Department of Neuroradiology, APHM La Timone, Marseille, France.

Basile Kerleroux (B)

Sainte Anne Hospital, Paris, France.

Romain Bourcier (R)

Diagnostic and Interventional Neuroradiology Department, CHU Nantes, Nantes, France.

Gaultier Marnat (G)

Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.

Chrysanthi Papagiannaki (C)

Radiology, Rouen University Hospital, Rouen, France.

Nader-Antoine Sourour (NA)

Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France.

Frédéric Clarençon (F)

Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France.
Sorbonne University, Paris, France.

Eimad Shotar (E)

Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France eimad.shotar@aphp.fr.
INSERM, CNRS, Vision Institute, Sorbonne University, Paris, France.

Classifications MeSH