Intracranial Aneurysm Classifier Using Phenotypic Factors: An International Pooled Analysis.

Journal Paper/Review - Aug 30, 2022


Morel S, Hostettler I, Spinner G, Bourcier R, Pera J, Meling T, Alg V, Houlden H, Bakker M, Van't Hof F, Rinkel G, Foroud T, Lai D, Moomaw C, Worrall B, Caroff J, Constant-Dits-Beaufils P, Karakachoff M, Rimbert A, Rouchaud A, Gaal-Paavola E, Kaukovalta H, Kivisaari R, Laakso A, Jahromi B, Tulamo R, Friedrich C, Dauvillier J, Hirsch S, Isidor N, Kulcsàr Z, Lovblad K, Martin O, Machi P, Mendes Pereira V, Rüfenacht D, Schaller K, Schilling S, Slowik A, Jaaskelainen J, von Und Zu Fraunberg M, Jiménez-Conde J, Cuadrado-Godia E, Soriano-Tárraga C, Millwood I, Walters R, The neurIST Project, The Ican Study Group, Genetics And Observational Subarachnoid Haemorrhage Gosh Study Investigators, International Stroke Genetics Consortium Isgc, Kim H, Redon R, Ko N, Rouleau G, Lindgren A, Niemelä M, Desal H, Woo D, Broderick J, Werring D, Ruigrok Y, Bijlenga P. Intracranial Aneurysm Classifier Using Phenotypic Factors: An International Pooled Analysis. J Pers Med 2022; 12
Journal Paper/Review (English)
J Pers Med 2022; 12
Publication Date
Aug 30, 2022
Issn Print
Brief description/objective

Intracranial aneurysms (IAs) are usually asymptomatic with a low risk of rupture, but consequences of aneurysmal subarachnoid hemorrhage (aSAH) are severe. Identifying IAs at risk of rupture has important clinical and socio-economic consequences. The goal of this study was to assess the effect of patient and IA characteristics on the likelihood of IA being diagnosed incidentally versus ruptured. Patients were recruited at 21 international centers. Seven phenotypic patient characteristics and three IA characteristics were recorded. The analyzed cohort included 7992 patients. Multivariate analysis demonstrated that: (1) IA location is the strongest factor associated with IA rupture status at diagnosis; (2) Risk factor awareness (hypertension, smoking) increases the likelihood of being diagnosed with unruptured IA; (3) Patients with ruptured IAs in high-risk locations tend to be older, and their IAs are smaller; (4) Smokers with ruptured IAs tend to be younger, and their IAs are larger; (5) Female patients with ruptured IAs tend to be older, and their IAs are smaller; (6) IA size and age at rupture correlate. The assessment of associations regarding patient and IA characteristics with IA rupture allows us to refine IA disease models and provide data to develop risk instruments for clinicians to support personalized decision-making.