Abstract TP80: Incidence And Risk Factors For The Growth And Rupture Of Unruptured Cerebral Aneurysms. Results Of Annual Radiologic Follow Up Study.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Katsumi Matsumoto ◽  
Kouichirou Tsuruzono ◽  
Manabu Sasaki ◽  
Noriyasu Yoshimura ◽  
Toshiki Yoshimine ◽  
...  
Keyword(s):  
Growth Rate ◽  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Annual Growth ◽  
Annual Growth Rate ◽  
Rupture Rate ◽  
Follow Up Study ◽  
Factors Influencing ◽  
Unruptured Cerebral Aneurysms

Background: The recent trend of the treatment of unruptured cerebral aneurysms(UIAs) is going to be conservative. Their natural history of rupture and growth is still unkown. We present the results of annual radiological follow-up study in UIAs. Method: In recent 12 years, we have found 121patients with 148 unruptured cerebral aneurysms were followed annually using 3D-CTA or MRA. Mean follow-up period was 5.5 year. Several factors influencing rupture or growth were statistically examined. Results: Among 121 patients, 9 ruptured and 11 showed growth of UIAs. Annual rupture rate was 1.3% per year and annual growth rate was 1.6% per year. Aneurysm size was the sole factor influencing rupture(P<0.001), whereas female sex and multiplicity were major factors influencing aneurysm growth(P<0.05). Under size 3mm, annual growth rate was 3.0% whereas annual rupture rate was 0.7%. In 4-6mm, growth rate was 1.6% and rupture rate was 1.6%. In 7-9mm, growth rate was 0 and rupture rate was 5.8%. In over 10mm, growth rate was 2.9% and rupture rate was 11.6%. Within 1 year, rupture occurred in 4 cases, and growth was found in 1 case. Conclusions: By annual radiological examination, growth of UIAs was noted more frequently than aneurysm rupture. Especially UIAs under 3mm, growth was 4 times higher than rupture, radiological follow up is effective for aneurysm rupture. Within 1 year, initially found UIAs should be carefully followed in a short interval.

Relationship of Growth to Aneurysm Rupture in Asymptomatic Aneurysms ≤ 7 mm: A Systematic Analysis of the Literature

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. 1164-1171 ◽  
Author(s):  
Mohamad Chmayssani ◽  
Jean G. Rebeiz ◽  
Tania J. Rebeiz ◽  
H. Hunt Batjer ◽  
Bernard R. Bendok
Keyword(s):  
Growth Rate ◽  
Natural History ◽  
Aneurysm Rupture ◽  
Annual Growth ◽  
Diameter Growth ◽  
Annual Growth Rate ◽  
Rupture Risk ◽  
Unruptured Aneurysms ◽  
Aneurysm Growth

Abstract BACKGROUND: The apparent paradox of natural history data suggesting low rupture risk of small asymptomatic aneurysms and the median size of aneurysm rupture remains unexplained. Aneurysm growth rates and their potential relationship with rupture risk have not been well examined in natural history studies. OBJECTIVE: To examine the question of whether small asymptomatic aneurysms ≤ 7 mm that are followed up over time rupture and to determine the relationship between aneurysm growth and rupture. METHODS: We reviewed all publications on unruptured aneurysms published from 1966 to 2009. We then selected all aneurysms ≤ 7 mm for which measurements were reported for at least 2 time points and for which initial asymptomatic status and ultimate outcome (rupture vs unruptured) were reported. Using the Mann-Whitney U test, we compared absolute diameter annual growth rate. RESULTS: Our search retrieved 64 aneurysms. Thirty aneurysms ruptured during follow-up, of which 27 were enlarged before rupture (90%). Thirty-four aneurysms did not rupture, of which 24 enlarged during follow-up (71%). There was a statistically significant trend toward larger absolute diameter growth for ruptured aneurysms vs unruptured aneurysms (3.89 ± 2.34 vs 1.79 ± 1.02 mm; P &lt; .001), respectively. Annual growth rates for aneurysms for the 2 groups, however, were not statistically different (27.46 ± 18.76 vs 32.00 ± 29.30; P = .92). CONCLUSION: Small aneurysms are prone to growth and rupture. Aneurysm rupture is more likely to occur in aneurysms with larger absolute diameter growth, but rupture can also occur in the absence of growth. The annual growth rate in both groups suggests that rate of growth of aneurysms is highly variable and unpredictable, justifying treatment or close diagnostic follow-up.

Follow-up Study on Intra-Aneurysmal Embolization for Unruptured Cerebral Aneurysms

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 89-92 ◽  
Author(s):  
Y. Kaku ◽  
S. Yoshimura ◽  
K. Hayashi ◽  
T. Ueda ◽  
N. Sakai
Keyword(s):  
Lower Incidence ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Neurological Deficits ◽  
Safe Treatment ◽  
Unruptured Aneurysms ◽  
Follow Up Study ◽  
Platinum Coil ◽  
Unruptured Cerebral Aneurysms

We describe follow-up clinical and angiographical results in patients with unruptured cerebral aneurysms treated with IDC or GDC. In 28 patients who underwent intra-aneurysmal occlusion for unruptured aneurysms, there were no permanent neurological deficits in the periprocedural period, while three transient neurological deficits were observed. On the angiograms obtained immediately after the procedure, complete aneurysmal occlusion was achieved in three patients (10.7%), a small neck remnant was detected in two cases (7.1%), a body filling in 12 cases (42.9%) and both of them were detected in 11 patients (39.3%). On the follow up angiograms (median angiographical follow-up period 15.6 months), 46.4% of incompletely obliterated aneurysms showed aneurysmal recanalization, and a incompletely embolized aneurysm ruptured 15 months after initial embolization. Detachable platinum coil embolization is a safe treatment for unruptured aneurysms with a lower incidence of peri-procedural morbidity, wheareas follow-up results are less satisfactory in cases involving incompletely obliterated lesions. With this limitation in mind, patients need to be very carefully chosen for GDC embolization and strict follow-up angiography is mandatory when a complete embolization is not achieved.

How definitive treatment affects the rupture rate of unruptured cerebral aneurysms: a competing risk survival analysis

2020 ◽  
Vol 132 (4) ◽  
pp. 1062-1067
Author(s):  
Toshikazu Kimura ◽  
Chikayuki Ochiai ◽  
Kensuke Kawai ◽  
Akio Morita ◽  
Nobuhito Saito
Keyword(s):  
Competing Risks ◽  
Cumulative Incidence ◽  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Competing Risk ◽  
Definitive Treatment ◽  
Rupture Rate ◽  
Kaplan Meier ◽  
Risk Event ◽  
Unruptured Cerebral Aneurysms

OBJECTIVETo investigate the risk of bleeding from unruptured cerebral aneurysms (UCAs), previous studies have used Kaplan-Meier analyses without treating the definitive treatment as a competing risk event, which may underestimate the rupture rate. The authors analyzed the survival of patients with UCAs alongside the occurrence of aneurysm bleeding and its competing risk events.METHODSA retrospective analysis was conducted on 722 patients diagnosed with UCAs in the period from 2000 to 2009 using an institution’s electronic medical records and telephone interviews. The cumulative incidence of aneurysm rupture was examined, and factors contributing to rupture were assessed using regression analyses.RESULTSBy 2014, 19 patients had experienced aneurysm rupture, with an overall rupture rate of 0.57% per year over 3320.8 person-years. However, cumulative incidence analysis indicated that 1.3% of all patients had a rupture within 2 years after aneurysm identification, and 38.4% of the patients underwent definitive treatment in the same period. Among the patients who experienced rupture, regression analysis revealed that an aneurysm size greater than 5 mm, a location in the anterior or posterior communicating arteries, and an irregular shape contributed to aneurysm rupture, with HRs of 4.4 (95% CI 1.2–15.7), 3.5 (95% CI 1.4–8.7), and 2.1 (95% CI 0.7–6.0), respectively.CONCLUSIONSRupture rate analyses using the person-year or standard Kaplan-Meier method are not as informative without consideration of the competing risks. The incidence of aneurysm rupture should be presented clearly with those of competing risks.

scholarly journals Comparative Evaluation of Top-Down GOSAT XCO2 vs. Bottom-Up National Reports in the European Countries

2021 ◽  
Vol 13 (12) ◽  
pp. 6700
Author(s):  
Youngseok Hwang ◽  
Stephan Schlüter ◽  
Tanupriya Choudhury ◽  
Jung-Sup Um
Keyword(s):  
Climate Change ◽  
Growth Rate ◽  
Greenhouse Gases ◽  
Annual Growth ◽  
Annual Growth Rate ◽  
Top Down ◽  
Bottom Up ◽  
European Continent ◽  
Anthropogenic Carbon

Submitting national inventory reports (NIRs) on emissions of greenhouse gases (GHGs) is obligatory for parties of the United Nations Framework Convention on Climate Change (UNFCCC). The NIR forms the basis for monitoring individual countries’ progress on mitigating climate change. Countries prepare NIRs using the default bottom–up methodology of the Intergovernmental Panel on Climate Change (IPCC), as approved by the Kyoto protocol. We provide tangible evidence of the discrepancy between official bottom–up NIR reporting (unit: tons) versus top–down XCO2 reporting (unit: ppm) within the European continent, as measured by the Greenhouse Gases Observing Satellite (GOSAT). Bottom–up NIR (annual growth rate of CO2 emission from 2010 to 2016: −1.55%) does not show meaningful correlation (geographically weighted regression coefficient = −0.001, R2 = 0.024) to top–down GOSAT XCO2 (annual growth rate: 0.59%) in the European countries. The top five countries within the European continent on carbon emissions in NIR do not match the top five countries on GOSAT XCO2 concentrations. NIR exhibits anthropogenic carbon-generating activity within country boundaries, whereas satellite signals reveal the trans-boundary movement of natural and anthropogenic carbon. Although bottom–up NIR reporting has already gained worldwide recognition as a method to track national follow-up for treaty obligations, the single approach based on bottom–up did not present background atmospheric CO2 density derived from the air mass movement between the countries. In conclusion, we suggest an integrated measuring, reporting, and verification (MRV) approach using top–down observation in combination with bottom–up NIR that can provide sufficient countrywide objective evidence for national follow-up activities.

Abstract 200: Risk Factors Positively Associated with Annual Growth Rate of Brain Aneurysms

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Aichi Chien ◽  
Michelle Hildebrandt ◽  
Rashida Callender ◽  
Yuanqing Ye
Keyword(s):  
Risk Factors ◽  
Growth Rate ◽  
Family History ◽  
Positive Family History ◽  
High Growth ◽  
Aneurysm Rupture ◽  
Patient Specific ◽  
Annual Growth Rate ◽  
Aneurysm Growth

Introduction: Previous studies have shown that unruptured intracranial aneurysm (UIA) growth and rupture are strongly associated with each other, with an increasing number of aneurysms followed clinically, especially UIA smaller than 7 mm. Hypothesis: Patient-specific and aneurysm-specific clinical and demographic features can predict growth and growth rates of UIA. Methods: We studied a cohort of 293 individuals diagnosed with a total of 409 intracranial aneurysms followed for an average of 27.4 months. Associations with aneurysm growth and growth rate were identified for both patient- and aneurysm-specific variables. Growth was defined as a size increase greater than 0.6 mm, with growth rate (mm/year) determined from the change in size of the aneurysm between the first and last measurement. Results: Mean initial size at diagnosis was significantly associated with risk of growth (OR: 1.09, 95% CI: 1.01-1.18, p=0.036), as was diagnosis of multiple aneurysms (OR: 2.01, 95% CI: 1.00-4.04, p=0.048) and having a positive family history (OR: 4.25, 95% CI: 1.18-15.3, p=0.041). Diagnosis of coronary artery disease (CAD) (p<0.001), diabetes (p=0.041), and gender (p=0.014) were significant for growth rate. Differences were observed for aneurysms located in different vessels, with an increased occurrence of growth at M-Bifurcation (p=0.015 vs. other MCA sites) and a high growth rate for those located in the BA trunk (p=0.0033 vs. other VABA sites). Conclusions: This analysis takes advantage of a large longitudinal cohort with multiple follow-up measurements to provide further insight regarding the characteristics of UIA growth behavior. While our data further confirm that aneurysm rupture and growth share a similar set of risk factors (size, multiplicity and family history), we additionally that found patients with CAD or diabetes had a higher aneurysm growth rate, and therefore might require more frequent follow up.

scholarly journals Stent-Assisted Coil Embolization of Complex Wide-Necked Bifurcation Cerebral Aneurysms Using the “Waffle Cone” Technique

2012 ◽  
Vol 18 (1) ◽  
pp. 20-28 ◽  
Author(s):  
W. Liu ◽  
D.K. Kung ◽  
B. Policeni ◽  
J.D. Rossen ◽  
P.M. Jabbour ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Published Data ◽  
Catheter Angiography ◽  
Follow Up Study ◽  
Small Series ◽  
Relative Safety ◽  
Aneurysm Occlusion ◽  
Ischemic Attack

Endovascular treatment of complex, wide-necked bifurcation cerebral aneurysms is challenging. Intra/extra-aneurysmal stent placement, the “waffle cone” technique, has the advantage of using a single stent to prevent coil herniation without the need to deliver the stent to the efferent vessel. The published data on the use of this technique is limited. We present our initial and follow-up experience with the waffle cone stent-assisted coiling (SAC) of aneurysms to evaluate the durability of the technique. We retrospectively identified ten consecutive patients who underwent SAC of an aneurysm using the waffle cone technique from July 2009 to March 2011. Clinical and angiographic outcomes after initial treatment and follow-up were evaluated. Raymond Class I or II occlusion of the aneurysm was achieved in all cases with the waffle cone technique. No intraoperative aneurysm rupture was noted. The parent arteries were patent at procedure completion. Clinical follow-up in nine patients (median 12.9 months) revealed no aneurysm rupture. Two patients had a transient embolic ischemic attack at 18 hours and three months after treatment, respectively. Catheter angiography or MRA at six-month follow-up demonstrated persistent occlusions of aneurysms in seven out of eight patients. Another patient had stable aneurysm occlusion at three-month follow-up study. Our experience in the small series suggests the waffle cone technique could be performed on complex, wide-necked aneurysms with relative safety, and it allowed satisfactory occlusions of the aneurysms at six months in most cases.

Ageing Saudi Population in the Facebook Era

2018 ◽  
Author(s):  
Asharaf Abdul Salam
Keyword(s):  
Growth Rate ◽  
Saudi Arabia ◽  
Population Ageing ◽  
Annual Growth ◽  
Annual Growth Rate ◽  
Saudi Population ◽  
Aged Population ◽  
Facebook Usage

<p>Data pertaining to 1974, 1992, 2004 and 2010 Censuses in Saudi Arabia was collected. Some reviews and literature on population ageing in Saudi Arabia as well as Facebook usage obtained. Statistics pertaining to Saudi population was utilized.</p> <p>Aged population in 2010 estimated by assuming the annual growth rate of 1974-2004.</p>

scholarly journals Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shouling Wu ◽  
Luli Xu ◽  
Mingyang Wu ◽  
Shuohua Chen ◽  
Youjie Wang ◽  
...  
Keyword(s):  
Growth Rate ◽  
Linear Regression ◽  
Arterial Stiffness ◽  
Multivariate Linear Regression ◽  
Annual Growth ◽  
Annual Growth Rate ◽  
Cross Sectional ◽  
Tyg Index ◽  
Longitudinal Association ◽  
The Cross

Abstract Background Triglyceride–glucose (TyG) index, a simple surrogate marker of insulin resistance, has been reported to be associated with arterial stiffness. However, previous studies were limited by the cross-sectional design. The purpose of this study was to explore the longitudinal association between TyG index and progression of arterial stiffness. Methods A total of 6028 participants were derived from the Kailuan study. TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). Arterial stiffness progression was assessed by the annual growth rate of repeatedly measured baPWV. Multivariate linear regression models were used to estimate the cross-sectional association of TyG index with baPWV, and Cox proportional hazard models were used to investigate the longitudinal association between TyG index and the risk of arterial stiffness. Results Multivariate linear regression analyses showed that each one unit increase in the TyG index was associated with a 39 cm/s increment (95%CI, 29–48 cm/s, P < 0.001) in baseline baPWV and a 0.29 percent/year increment (95%CI, 0.17–0.42 percent/year, P < 0.001) in the annual growth rate of baPWV. During 26,839 person-years of follow-up, there were 883 incident cases with arterial stiffness. Participants in the highest quartile of TyG index had a 58% higher risk of arterial stiffness (HR, 1.58; 95%CI, 1.25–2.01, P < 0.001), as compared with those in the lowest quartile of TyG index. Additionally, restricted cubic spline analysis showed a significant dose–response relationship between TyG index and the risk of arterial stiffness (P non-linearity = 0.005). Conclusion Participants with a higher TyG index were more likely to have a higher risk of arterial stiffness. Subjects with a higher TyG index should be aware of the following risk of arterial stiffness progression, so as to establish lifestyle changes at an early stage.

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