Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Natural History of Unruptured Intracranial Aneurysms : A Retrospective Single Center Analysis

  • Byoun, Hyoung Soo (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Huh, Won (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Oh, Chang Wan (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Bang, Jae Seung (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Hwang, Gyojun (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Kwon, O-Ki (Department of Neurosurgery, Seoul National University Bundang Hospital)
  • Received : 2013.11.12
  • Accepted : 2015.12.01
  • Published : 2016.01.01
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Abstract

Objective : We conducted a retrospective cohort study to elucidate the natural course of unruptured intracranial aneurysms (UIAs) at a single institution. Methods : Data from patients diagnosed with UIA from March 2000 to May 2008 at our hospital were subjected to a retrospective analysis. The cumulative and annual aneurysm rupture rates were calculated. Additionally, risk factors associated with aneurysmal rupture were identified. Results : A total of 1339 aneurysms in 1006 patients met the inclusion criteria. During the follow-up period, 685 aneurysms were treated before rupture via either an open surgical or endovascular procedure. Six hundred fifty-four UIAs were identified and not repaired during the follow-up period. The mean UIA size was $4.5{\pm}3.2mm$, and 86.5% of the total UIAs had a largest dimension <7 mm. Among these UIAs, 18 ruptured at a median of 1.6 years (range : 27 days to 9.8 years) after day 0. The annual rupture risk during a 9-year follow-up was 1.00%. A multivariate Cox proportional hazards analysis revealed that the aneurysm size and a history of subarachnoid hemorrhage (SAH) were statistically significant risk factors for rupture. For an aneurysms smaller than 7 mm in the absence of a history of SAH, the annual rupture risk was 0.79%. Conclusion : In our study, the annual rupture risk for UIAs smaller than 7 mm in the absence of a history of SAH was higher than that of Western populations but similar to that of the Japanese population.

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References

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