1. Predictors of Occurrence and Anatomic Distribution of Multiple Aneurysms in Patients with Aneurysmal Subarachnoid Hemorrhage
- Author
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Michel Roethlisberger, Rita Achermann, Schatlo Bawarjan, Martin N. Stienen, Christian Fung, Donato D'Alonzo, Nicolai Maldaner, Andrea Ferrari, Marco V. Corniola, Daniel Schöni, Daniele Valsecchi, Rodolfo Maduri, Martin A. Seule, Jan-Karl Burkhardt, Serge Marbacher, Philippe Bijlenga, Kristine A. Blackham, Heiner C. Bucher, Luigi Mariani, Raphael Guzman, Daniel W. Zumofen, Javier Fandino, Daniel Colluccia, Marta Arrighi, Alice Venier, Dominique E. Kuhlen, Thomas Robert, Michael Reinert, Astrid Weyerbrock, Martin Hlavica, Jean-Yves Fournier, Andreas Raabe, Juergen Beck, David Bervini, Karl Schaller, Roy T. Daniel, Daniele Starnoni, Mahmoud Messerer, Marc Levivier, Emanuela Keller, Luca Regli, Oliver Bozinov, Sina Finkenstaedt, Luca Remonda, Christoph Stippich, Jan Gralla, Zsolt Kulcsar, Vitor Mendes-Pereira, Peter Ahlborn, Nicolas R. Smoll, Veit Rohde, Sina Tok, Fabian Baumann, Karl Kothbauer, Hassen Kerkeni, Hiroki Dan-Ura, Hans Landolt, Khaled Mostaguir, Yvan Gasche, Asita Sarrafzadeh, Gerhard Hildebrandt, Kerstin Winkler, Christoph Woernle, Rene Bernays, University of Zurich, Zumofen, Daniel W, Robert, Thomas, Fournier, Jean-Yves, Schaller, Karl Lothard, Kulcsar, Zsolt, Baumann, Fabian, Mostaguir, Khaled, Gasche, Yvan, and Sarrafzadeh-Khorassani, Asita Simone
- Subjects
Adult ,Male ,medicine.medical_specialty ,Subarachnoid hemorrhage ,610 Medicine & health ,030218 nuclear medicine & medical imaging ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,10043 Clinic for Neuroradiology ,medicine ,Humans ,cardiovascular diseases ,Registries ,Risk factor ,Aged ,business.industry ,Retrospective cohort study ,Intracranial Aneurysm ,Odds ratio ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Confidence interval ,ddc:616.8 ,2746 Surgery ,2728 Neurology (clinical) ,Cohort ,cardiovascular system ,Aneurysm multiplicity ,Surgery ,Female ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Switzerland ,Cohort study - Abstract
Background The literature on multiple intracranial aneurysms (MIA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) focuses largely on risk factor analysis and consists essentially of retrospective cohort studies of limited sample size, or studies in populations outside Europe and North America. The purpose of this cohort study was to identify predictors for aneurysm multiplicity and to investigate the anatomic distribution of MIA in a representative Western cohort of patients with aSAH. Methods The Swiss Study of Subarachnoid Hemorrhage (SOS) database includes anonymized data from all tertiary neurovascular facilities in Switzerland. The dataset for 2009–2014 was used to compare characteristics of patients with aSAH and MIA and those with a single intracranial aneurysm (SIA) by means of descriptive and multivariate regression analysis. Results Among 1689 unselected patients with aSAH, 467 had MIA (prevalence, 27.6%). The location of the ruptured index aneurysm was correlated with the probability of finding bystander aneurysms and predicted their likely anatomic distribution. Patients with a ruptured basilar artery aneurysm (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.30–3.44) or a ruptured middle cerebral artery aneurysm (OR, 1.86; 95% CI, 1.35–2.55) were at the greatest risk for having MIA. Larger size of the index aneurysm (OR per 1 mm, 1.03; 95% CI, 1.01–1.06) was also positively correlated with aneurysm multiplicity. Males were less likely than females to have MIA (OR, 0.79; 95% CI, 0.61–1.01). Conclusions In patients with aSAH, the location of the ruptured index aneurysm is correlated with the probability of finding bystander aneurysms, and is predictive of the sites at which bystander aneurysms are most likely to be found.
- Published
- 2017