gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Can ISUIA conclusions be applied to all anterior circulation aneurysms?

Meeting Abstract

  • M. Jägersberg - Klinik für Neurochirurgie, UniversitätsSpital Genf
  • K. Schaller - Klinik für Neurochirurgie, UniversitätsSpital Genf
  • A. Rogers Rodriguez - Klinik für Neurochirurgie, UniversitätsSpital Genf
  • V. Mendes Pereira - Abteilung für interventionelle Radiologie, UniversitätsSpital Genf
  • P. Bijlenga - Klinik für Neurochirurgie, UniversitätsSpital Genf

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.11.01

DOI: 10.3205/11dgnc078, URN: urn:nbn:de:0183-11dgnc0788

Veröffentlicht: 28. April 2011

© 2011 Jägersberg et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: According to the International Study of Unruptured Intracranial Aneurysms (ISUIA), anterior circulation (anterior and middle cerebral and internal carotid artery) aneurysms less than 7mm in diameter carry a minimal risk of rupture. However, it is general neurosurgical experience that anterior communicating artery (Acom) aneurysms are frequent and most measuring 7 mm rupture. Do Acom aneurysms behave differently from other anterior circulation aneurysms?

Methods: We studied the prospectively recruited patients of the multicenter @neurIST project. The prevalence of unruptured aneurysms by location was compared between ISUIA reported figures and @aneurIST data. The odds ratio of aneurysm rupture was compared between Acom and anterior circulation, middle cerebral artery, internal carotid artery and posterior circulation locations. Average sizes of unruptured and ruptured aneurysms were calculated.

Results: Of 263 unruptured aneurysms in the @neurIST study, 207 (78%) were found in the anterior circulation (ISUIA 61%) and among these 48 (23%) were Acom aneurysms (ISUIA 10,3% for both anterior cerebral artery and Acom). The higher incidence of these aneurysms in the @neurIST collective was significant (p<0.001).The odds ratios for aneurysm rupture between the Acom and anterior circulation, middle cerebral artery, internal carotid artery and posterior circulation locations were 2.72, 3.96, 6.45 and 1.45, respectively. Unruptured and ruptured aneurysm sizes were 6.29±4.43 mm and 6.79±7.2 mm for the Acom, 5.98±4.56 mm and 6.76±8.35 mm for the internal carotid artery, 5.25±3.66 mm, 7.09±5.67 mm for the middle cerebral artery and 5.34±6.37 mm for the posterior circulation, respectively.

Conclusions: The prevalence of unruptured aneurysms of the anterior circulation is significantly higher in the @neurIST study than reported in ISUIA. Acom is the most frequent location of aneurysms observed in @neurIST. Acom aneurysms are mostly discovered after rupture and behave similarly to posterior circulation aneurysms in contrast to middle cerebral and internal carotid artery aneurysms. We therefore suggest that anterior circulation conclusions of ISUIA can not be applied to Acom aneurysms.