Morphological Characteristics of Ruptured Brain Aneurysms: A Systematic Literature Review and Meta‐Analysis

Background It is unclear what morphological features of brain aneurysms are better at predicting risk of rupture. We conducted a meta‐analysis to analyze the best morphological determinants of rupture status. Methods The Nested Knowledge platform was used to perform a search of articles reporting on aneurysm size, aspect ratio (AR), size ratio (SR), ellipticity index, nonsphericity index, and undulation index. The mean differences between ruptured and unruptured aneurysms were used to calculate effect sizes. Results A total of 63 studies with 13 025 aneurysms were included: 6966 ruptured aneurysms and 6059 unruptured aneurysms. Ruptured aneurysms had a larger size (P