Growth of Untreated Unruptured Small-sized Aneurysms (≺7mm): Incidence and Related Factors
Purpose The need to treat small (
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| Veröffentlicht in: | Clinical neuroradiology (Munich) 2018-06, Vol.28 (2), p.183-189 |
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| creator | Choi, Hyun Ho Cho, Young Dae Jeon, Jin Pyeong Yoo, Dong Hyun Moon, Jusun Lee, Jeongjun Kang, Hyun-Seung Cho, Won-Sang Kim, Jeong Eun Zhang, Li Han, Moon Hee |
| description | Purpose
The need to treat small ( |
| doi_str_mv | 10.1007/s00062-017-0559-y |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1865537207</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A718270664</galeid><sourcerecordid>A718270664</sourcerecordid><originalsourceid>FETCH-LOGICAL-c505t-29e54eefcfdbb4759dc23d5319ecbfc66be11134502c50d0bfc0db2ea8e50ae23</originalsourceid><addsrcrecordid>eNp1kcFqFTEUhoMottQ-gBsZcFMXU0-SyWTG3aXYWigIandCyCRn6pSZ5JrMINc36Cv1cXwSz_XWFkXJIj_J9_-c5GfsOYdjDqBfZwCoRQlcl6BUW24esX3e1G3Jq0o_vtey3WOHOV8TDbJpldJP2Z5ouAIh5D77fJbit_lLEfviMswJ7YyeVFrW85JIfpzsOJZ5-E56FXBJmzzl4ujHza2epldvivPgBo_BYWGDLz7g-Cvg1Lo5pvyMPentmPHwbj9gl6dvP528Ky_en52frC5Kp0DNpWhRVYi9633XVVq13gnpleQtuq53dd0h51xWNDIZPNAZ-E6gbVCBRSEP2NEud53i1wXzbKYhOxxHGzAu2dBXKCW1AE3oy7_Q67ikQNMZAZVqpeZCPFBXdkQzhD7OybptqFlp3ggNdV0RdfwPipbHaXAxYD_Q-R8GvjO4FHNO2Jt1GiabNoaD2ZZqdqUaKtVsSzUb8ry4G3jpJvT3jt8VEiB2QKarcIXp4UX_T_0JK9WsAg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2045937122</pqid></control><display><type>article</type><title>Growth of Untreated Unruptured Small-sized Aneurysms (≺7mm): Incidence and Related Factors</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Choi, Hyun Ho ; Cho, Young Dae ; Jeon, Jin Pyeong ; Yoo, Dong Hyun ; Moon, Jusun ; Lee, Jeongjun ; Kang, Hyun-Seung ; Cho, Won-Sang ; Kim, Jeong Eun ; Zhang, Li ; Han, Moon Hee</creator><creatorcontrib>Choi, Hyun Ho ; Cho, Young Dae ; Jeon, Jin Pyeong ; Yoo, Dong Hyun ; Moon, Jusun ; Lee, Jeongjun ; Kang, Hyun-Seung ; Cho, Won-Sang ; Kim, Jeong Eun ; Zhang, Li ; Han, Moon Hee</creatorcontrib><description>Purpose
The need to treat small (<7 mm) unruptured aneurysms is still controversial, despite data collected through several large cohort studies. Such lesions typically are incidental findings, usually followed for potential growth through serial imaging. For this study, growth estimates for untreated unruptured small-sized aneurysms were generated, examining incidence and related risk factors.
Methods
A cohort of 135 consecutive patients harboring 173 untreated unruptured small-sized aneurysms (<7 mm) was subjected to extended monitoring (mean, 73.1 ± 30.0 months). Growth was defined as a 1-mm increase at minimum in one or more aneurysmal dimensions or as a significant change in shape. Medical records and radiological data were reviewed. Cumulative growth rate and related risk factors were analyzed via Cox proportional hazards regression and Kaplan-Meier product-limit estimator.
Results
A total of 28 aneurysms (16.2%) displayed growth during continued surveillance (1054.1 aneurysm-years). The annual growth rate was 2.65% per aneurysm-year, with 15 surfacing within 60 months and 13 after 60 months. Multivariate analysis indicated that bifurcation type was the sole significant risk factor (hazard ratio HR = 7.64;
p
< 0.001) in terms of growth. Cumulative survival rates without growth were significantly lower in subjects with bifurcation aneurysms than with side-wall aneurysms (
p
< 0.001). During the follow-up period, one patient suffered a subarachnoid hemorrhage and then aneurysm growth was detected.
Conclusion
Most (83.8%) untreated unruptured small-sized aneurysms (<7 mm) remained stable and devoid of growth in long-term follow-up. Because bifurcation aneurysms were prone to eventual growth, careful long-term monitoring at regular intervals is advised if left untreated.</description><identifier>ISSN: 1869-1439</identifier><identifier>EISSN: 1869-1447</identifier><identifier>DOI: 10.1007/s00062-017-0559-y</identifier><identifier>PMID: 28150223</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aneurysm, Ruptured ; Aneurysms ; Cohort Studies ; Female ; Growth rate ; Humans ; Incidence ; Intracranial Aneurysm - complications ; Intracranial Aneurysm - pathology ; Male ; Medical colleges ; Medical records ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Neurology ; Neuroradiology ; Neurosurgery ; Original Article ; Risk Factors ; Stroke (Disease) ; Subarachnoid Hemorrhage - etiology</subject><ispartof>Clinical neuroradiology (Munich), 2018-06, Vol.28 (2), p.183-189</ispartof><rights>Springer-Verlag Berlin Heidelberg 2017</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Clinical Neuroradiology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-29e54eefcfdbb4759dc23d5319ecbfc66be11134502c50d0bfc0db2ea8e50ae23</citedby><cites>FETCH-LOGICAL-c505t-29e54eefcfdbb4759dc23d5319ecbfc66be11134502c50d0bfc0db2ea8e50ae23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00062-017-0559-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00062-017-0559-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28150223$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Hyun Ho</creatorcontrib><creatorcontrib>Cho, Young Dae</creatorcontrib><creatorcontrib>Jeon, Jin Pyeong</creatorcontrib><creatorcontrib>Yoo, Dong Hyun</creatorcontrib><creatorcontrib>Moon, Jusun</creatorcontrib><creatorcontrib>Lee, Jeongjun</creatorcontrib><creatorcontrib>Kang, Hyun-Seung</creatorcontrib><creatorcontrib>Cho, Won-Sang</creatorcontrib><creatorcontrib>Kim, Jeong Eun</creatorcontrib><creatorcontrib>Zhang, Li</creatorcontrib><creatorcontrib>Han, Moon Hee</creatorcontrib><title>Growth of Untreated Unruptured Small-sized Aneurysms (≺7mm): Incidence and Related Factors</title><title>Clinical neuroradiology (Munich)</title><addtitle>Clin Neuroradiol</addtitle><addtitle>Clin Neuroradiol</addtitle><description>Purpose
The need to treat small (<7 mm) unruptured aneurysms is still controversial, despite data collected through several large cohort studies. Such lesions typically are incidental findings, usually followed for potential growth through serial imaging. For this study, growth estimates for untreated unruptured small-sized aneurysms were generated, examining incidence and related risk factors.
Methods
A cohort of 135 consecutive patients harboring 173 untreated unruptured small-sized aneurysms (<7 mm) was subjected to extended monitoring (mean, 73.1 ± 30.0 months). Growth was defined as a 1-mm increase at minimum in one or more aneurysmal dimensions or as a significant change in shape. Medical records and radiological data were reviewed. Cumulative growth rate and related risk factors were analyzed via Cox proportional hazards regression and Kaplan-Meier product-limit estimator.
Results
A total of 28 aneurysms (16.2%) displayed growth during continued surveillance (1054.1 aneurysm-years). The annual growth rate was 2.65% per aneurysm-year, with 15 surfacing within 60 months and 13 after 60 months. Multivariate analysis indicated that bifurcation type was the sole significant risk factor (hazard ratio HR = 7.64;
p
< 0.001) in terms of growth. Cumulative survival rates without growth were significantly lower in subjects with bifurcation aneurysms than with side-wall aneurysms (
p
< 0.001). During the follow-up period, one patient suffered a subarachnoid hemorrhage and then aneurysm growth was detected.
Conclusion
Most (83.8%) untreated unruptured small-sized aneurysms (<7 mm) remained stable and devoid of growth in long-term follow-up. Because bifurcation aneurysms were prone to eventual growth, careful long-term monitoring at regular intervals is advised if left untreated.</description><subject>Aged</subject><subject>Aneurysm, Ruptured</subject><subject>Aneurysms</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Growth rate</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intracranial Aneurysm - complications</subject><subject>Intracranial Aneurysm - pathology</subject><subject>Male</subject><subject>Medical colleges</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Risk Factors</subject><subject>Stroke (Disease)</subject><subject>Subarachnoid Hemorrhage - etiology</subject><issn>1869-1439</issn><issn>1869-1447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kcFqFTEUhoMottQ-gBsZcFMXU0-SyWTG3aXYWigIandCyCRn6pSZ5JrMINc36Cv1cXwSz_XWFkXJIj_J9_-c5GfsOYdjDqBfZwCoRQlcl6BUW24esX3e1G3Jq0o_vtey3WOHOV8TDbJpldJP2Z5ouAIh5D77fJbit_lLEfviMswJ7YyeVFrW85JIfpzsOJZ5-E56FXBJmzzl4ujHza2epldvivPgBo_BYWGDLz7g-Cvg1Lo5pvyMPentmPHwbj9gl6dvP528Ky_en52frC5Kp0DNpWhRVYi9633XVVq13gnpleQtuq53dd0h51xWNDIZPNAZ-E6gbVCBRSEP2NEud53i1wXzbKYhOxxHGzAu2dBXKCW1AE3oy7_Q67ikQNMZAZVqpeZCPFBXdkQzhD7OybptqFlp3ggNdV0RdfwPipbHaXAxYD_Q-R8GvjO4FHNO2Jt1GiabNoaD2ZZqdqUaKtVsSzUb8ry4G3jpJvT3jt8VEiB2QKarcIXp4UX_T_0JK9WsAg</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Choi, Hyun Ho</creator><creator>Cho, Young Dae</creator><creator>Jeon, Jin Pyeong</creator><creator>Yoo, Dong Hyun</creator><creator>Moon, Jusun</creator><creator>Lee, Jeongjun</creator><creator>Kang, Hyun-Seung</creator><creator>Cho, Won-Sang</creator><creator>Kim, Jeong Eun</creator><creator>Zhang, Li</creator><creator>Han, Moon Hee</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20180601</creationdate><title>Growth of Untreated Unruptured Small-sized Aneurysms (≺7mm): Incidence and Related Factors</title><author>Choi, Hyun Ho ; Cho, Young Dae ; Jeon, Jin Pyeong ; Yoo, Dong Hyun ; Moon, Jusun ; Lee, Jeongjun ; Kang, Hyun-Seung ; Cho, Won-Sang ; Kim, Jeong Eun ; Zhang, Li ; Han, Moon Hee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-29e54eefcfdbb4759dc23d5319ecbfc66be11134502c50d0bfc0db2ea8e50ae23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aneurysm, Ruptured</topic><topic>Aneurysms</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Growth rate</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intracranial Aneurysm - complications</topic><topic>Intracranial Aneurysm - pathology</topic><topic>Male</topic><topic>Medical colleges</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Risk Factors</topic><topic>Stroke (Disease)</topic><topic>Subarachnoid Hemorrhage - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Hyun Ho</creatorcontrib><creatorcontrib>Cho, Young Dae</creatorcontrib><creatorcontrib>Jeon, Jin Pyeong</creatorcontrib><creatorcontrib>Yoo, Dong Hyun</creatorcontrib><creatorcontrib>Moon, Jusun</creatorcontrib><creatorcontrib>Lee, Jeongjun</creatorcontrib><creatorcontrib>Kang, Hyun-Seung</creatorcontrib><creatorcontrib>Cho, Won-Sang</creatorcontrib><creatorcontrib>Kim, Jeong Eun</creatorcontrib><creatorcontrib>Zhang, Li</creatorcontrib><creatorcontrib>Han, Moon Hee</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neuroradiology (Munich)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Hyun Ho</au><au>Cho, Young Dae</au><au>Jeon, Jin Pyeong</au><au>Yoo, Dong Hyun</au><au>Moon, Jusun</au><au>Lee, Jeongjun</au><au>Kang, Hyun-Seung</au><au>Cho, Won-Sang</au><au>Kim, Jeong Eun</au><au>Zhang, Li</au><au>Han, Moon Hee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Growth of Untreated Unruptured Small-sized Aneurysms (≺7mm): Incidence and Related Factors</atitle><jtitle>Clinical neuroradiology (Munich)</jtitle><stitle>Clin Neuroradiol</stitle><addtitle>Clin Neuroradiol</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>28</volume><issue>2</issue><spage>183</spage><epage>189</epage><pages>183-189</pages><issn>1869-1439</issn><eissn>1869-1447</eissn><abstract>Purpose
The need to treat small (<7 mm) unruptured aneurysms is still controversial, despite data collected through several large cohort studies. Such lesions typically are incidental findings, usually followed for potential growth through serial imaging. For this study, growth estimates for untreated unruptured small-sized aneurysms were generated, examining incidence and related risk factors.
Methods
A cohort of 135 consecutive patients harboring 173 untreated unruptured small-sized aneurysms (<7 mm) was subjected to extended monitoring (mean, 73.1 ± 30.0 months). Growth was defined as a 1-mm increase at minimum in one or more aneurysmal dimensions or as a significant change in shape. Medical records and radiological data were reviewed. Cumulative growth rate and related risk factors were analyzed via Cox proportional hazards regression and Kaplan-Meier product-limit estimator.
Results
A total of 28 aneurysms (16.2%) displayed growth during continued surveillance (1054.1 aneurysm-years). The annual growth rate was 2.65% per aneurysm-year, with 15 surfacing within 60 months and 13 after 60 months. Multivariate analysis indicated that bifurcation type was the sole significant risk factor (hazard ratio HR = 7.64;
p
< 0.001) in terms of growth. Cumulative survival rates without growth were significantly lower in subjects with bifurcation aneurysms than with side-wall aneurysms (
p
< 0.001). During the follow-up period, one patient suffered a subarachnoid hemorrhage and then aneurysm growth was detected.
Conclusion
Most (83.8%) untreated unruptured small-sized aneurysms (<7 mm) remained stable and devoid of growth in long-term follow-up. Because bifurcation aneurysms were prone to eventual growth, careful long-term monitoring at regular intervals is advised if left untreated.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28150223</pmid><doi>10.1007/s00062-017-0559-y</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1869-1439 |
| ispartof | Clinical neuroradiology (Munich), 2018-06, Vol.28 (2), p.183-189 |
| issn | 1869-1439 1869-1447 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Aged Aneurysm, Ruptured Aneurysms Cohort Studies Female Growth rate Humans Incidence Intracranial Aneurysm - complications Intracranial Aneurysm - pathology Male Medical colleges Medical records Medicine Medicine & Public Health Middle Aged Multivariate analysis Neurology Neuroradiology Neurosurgery Original Article Risk Factors Stroke (Disease) Subarachnoid Hemorrhage - etiology |
| title | Growth of Untreated Unruptured Small-sized Aneurysms (≺7mm): Incidence and Related Factors |
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