OBJECTIVE: To examine the association between various non-modifiable risk factors and aneurysm rupture in a large cohort of patients evaluated at a single institution.
METHODS: A retrospective analysis of patients admitted to a cerebrovascular facility between January 2006 and 2010 with a primary diagnosis of cerebral aneurysm. Aneurysms were divided into two groups: unruptured or ruptured. The dome diameter, aspect ratio (AR), location, sidedness, neck morphology, and multiplicity were entered into a central database. A full model was constructed and systematic removal of the least significant variables was performed in a sequential fashion until only those variables reaching significance remained.
RESULTS: We identified 2347 patients harboring 5134 individual aneurysms, of which 34.90% were ruptured and 65.09% were unruptured. 25.89% of aneurysms with a dome diameter < 10 mm and 58.33% of aneurysms with a dome > 10mm were ruptured on admission (p<0.0001). 52.44% of aneurysms with an AR > 1.6 presented following a rupture (p<0.0001). The highest incidence of rupture (69.21%) was observed in aneurysms with an AR > 1.6, dome diameter < 10mm, and a deviated neck. Deviated neck-type aneurysms had a significantly greater incidence of rupture than classical neck-type aneurysms (p<0.0001).
CONCLUSION: An AR > 1.6, dome diameter > 10mm, a deviated neck, and right-sidedness are independently associated with aneurysm rupture.
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