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 < .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.

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.

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 Atorvastatin and growth, rupture of small unruptured intracranial aneurysm: results of a prospective cohort study

2021 ◽  
Vol 14 ◽  
pp. 175628642098793
Author(s):  
Jie Wang ◽  
Jiancong Weng ◽  
Hao Li ◽  
Yuming Jiao ◽  
Weilun Fu ◽  
...  
Keyword(s):  
Growth Rate ◽  
Cohort Study ◽  
Intracranial Aneurysm ◽  
Aneurysm Rupture ◽  
Uncontrolled Hypertension ◽  
Unruptured Intracranial Aneurysm ◽  
Multicenter Cohort Study ◽  
Aneurysm Growth ◽  
Cox Analysis

Background and aims: The role of statins in unruptured intracranial aneurysm (UIA) growth and rupture remains ambiguous. This study sought to determine whether atorvastatin is associated with aneurysm growth and rupture in patients harboring UIA <7 mm. Methods: This prospective, multicenter cohort study consecutively enrolled patients with concurrent UIA <7 mm and ischemic cerebrovascular disease from four hospitals between 2016 and 2019. Baseline and follow-up patient information was recorded. Because of the strong anti-inflammatory effect of aspirin, patients using aspirin were excluded. Patients taking atorvastatin 20 mg daily were atorvastatin users. The primary and exploratory endpoints were aneurysm rupture and growth, respectively. Results: Among the 1087 enrolled patients, 489 (45.0%) took atorvastatin, and 598 (55%) took no atorvastatin. After a mean follow-up duration of 33.0 ± 12.5 months, six (1.2%) and five (0.8%) aneurysms ruptured in atorvastatin and non-atorvastatin groups, respectively. In the adjusted multivariate Cox analysis, UIA sized 5 to <7 mm, current smoker, and uncontrolled hypertension were associated with aneurysm rupture, whereas atorvastatin [adjusted hazard ratio (HR) 1.495, 95% confidence interval (CI) 0.417–5.356, p = 0.537] was not. Of 159 patients who had follow-up imaging, 34 (21.4%) took atorvastatin and 125 (78.6%) took no atorvastatin. Aneurysm growth occurred in five (14.7%) and 21 (16.8%) patients in atorvastatin and non-atorvastatin groups (mean follow-up: 20.2 ± 12.9 months), respectively. In the adjusted multivariate Cox analysis, UIAs sized 5 to <7 mm and uncontrolled hypertension were associated with a high growth rate; atorvastatin (adjusted HR 0.151, 95% CI 0.031–0.729, p = 0.019) was associated with a reduced growth rate. Conclusions: We conclude atorvastatin use is associated with a reduced risk of UIA growth, whereas atorvastatin is not associated with UIA rupture. The trial registry name: The Clinic Benefit and Risk of Oral Aspirin for Unruptured Intracranial Aneurysm Combined With Cerebral Ischemia Clinical Trial Registration-URL: http://www.clinicaltrials.gov Unique identifier: NCT02846259

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.

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.

Assessing the rate, natural history, and treatment trends of intracranial aneurysms in patients with intracranial dural arteriovenous fistulas: a Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) investigation

2021 ◽  
pp. 1-10
Author(s):  
Isaac Josh Abecassis ◽  
R. Michael Meyer ◽  
Michael R. Levitt ◽  
Jason P. Sheehan ◽  
Ching-Jen Chen ◽  
...  
Keyword(s):  
Natural History ◽  
Arteriovenous Fistula ◽  
Outcomes Research ◽  
Intracranial Aneurysms ◽  
Dural Arteriovenous Fistula ◽  
Aneurysm Rupture ◽  
External Carotid ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas

OBJECTIVE There is a reported elevated risk of cerebral aneurysms in patients with intracranial dural arteriovenous fistulas (dAVFs). However, the natural history, rate of spontaneous regression, and ideal treatment regimen are not well characterized. In this study, the authors aimed to describe the characteristics of patients with dAVFs and intracranial aneurysms and propose a classification system. METHODS The Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) database from 12 centers was retrospectively reviewed. Analysis was performed to compare dAVF patients with (dAVF+ cohort) and without (dAVF-only cohort) concomitant aneurysm. Aneurysms were categorized based on location as a dAVF flow-related aneurysm (FRA) or a dAVF non–flow-related aneurysm (NFRA), with further classification as extra- or intradural. Patients with traumatic pseudoaneurysms or aneurysms with associated arteriovenous malformations were excluded from the analysis. Patient demographics, dAVF anatomical information, aneurysm information, and follow-up data were collected. RESULTS Of the 1077 patients, 1043 were eligible for inclusion, comprising 978 (93.8%) and 65 (6.2%) in the dAVF-only and dAVF+ cohorts, respectively. There were 96 aneurysms in the dAVF+ cohort; 10 patients (1%) harbored 12 FRAs, and 55 patients (5.3%) harbored 84 NFRAs. Dural AVF+ patients had higher rates of smoking (59.3% vs 35.2%, p < 0.001) and illicit drug use (5.8% vs 1.5%, p = 0.02). Sixteen dAVF+ patients (24.6%) presented with aneurysm rupture, which represented 16.7% of the total aneurysms. One patient (1.5%) had aneurysm rupture during follow-up. Patients with dAVF+ were more likely to have a dAVF located in nonconventional locations, less likely to have arterial supply to the dAVF from external carotid artery branches, and more likely to have supply from pial branches. Rates of cortical venous drainage and Borden type distributions were comparable between cohorts. A minority (12.5%) of aneurysms were FRAs. The majority of the aneurysms underwent treatment via either endovascular (36.5%) or microsurgical (15.6%) technique. A small proportion of aneurysms managed conservatively either with or without dAVF treatment spontaneously regressed (6.2%). CONCLUSIONS Patients with dAVF have a similar risk of harboring a concomitant intracranial aneurysm unrelated to the dAVF (5.3%) compared with the general population (approximately 2%–5%) and a rare risk (0.9%) of harboring an FRA. Only 50% of FRAs are intradural. Dural AVF+ patients have differences in dAVF angioarchitecture. A subset of dAVF+ patients harbor FRAs that may regress after dAVF treatment.

The Impact of COVID-19 on Energy Consumption in the United States: An Overview

2021 ◽  
Author(s):  
Lindsey Kahn ◽  
Hamidreza Najafi
Keyword(s):  
Growth Rate ◽  
Energy Consumption ◽  
Energy Use ◽  
The United States ◽  
Average Annual Growth Rate ◽  
Annual Growth ◽  
Annual Growth Rate ◽  
End User ◽  
End Use ◽  
The Impact

Abstract Lockdown measures and mobility restrictions implemented to combat the spread of the novel COVID-19 virus have impacted energy consumption patterns, particularly in the United States. A review of available data and literature on the impact of the pandemic on energy consumption is performed to understand the current knowledge on this topic. The overall decline of energy use during lockdown restrictions can best be identified through the analysis of energy consumption by source and end-user breakdown. Using monthly energy consumption data, the total 9-months use between January and September for the years 2015–2020 are calculated for each end-use. The cumulative consumption within these 9 months of the petroleum, natural gas, biomass, and electricity energy by the various end-use sectors are compared to identify a shift in use throughout time with the calculation of the percent change from 2019 to 2020. The analysis shows that the transportation sector experienced the most dramatic decline, having a subsequent impact on the primary energy it uses. A steep decline in the use of petroleum and natural gas by the transportation sector has had an inevitable impact on the emission of carbon dioxide and other air pollutants during the pandemic. Additionally, the most current data for the consumption of electricity by each state and each end-user in the times before and during the pandemic highlights the impact of specific lockdown procedures on energy use. The average total consumption for each state was found for the years 2015–2019. This result is used calculation of yearly growth rate and average annual growth rate in 2020 for each state and end-user. The total average annual growth rate for 2020 was used to find a correlation coefficient between COVID-19 case and death rates as well as population density and lockdown duration. To further examine the relationship a correlation coefficient was calculated between the 2020 average annual growth rate for all sectors and average annual growth rate for each individual end-user.

Authorship Pattern and Collaboration Coefficient of Library Professional’s Competency on Research Publications During 1999-2018: A Scientometric Analysis

2019 ◽  
Vol 9 (1) ◽  
pp. 85-89
Author(s):  
Nutan Gaud ◽  
M. P. Singh ◽  
Bhoopendra Singh
Keyword(s):  
Growth Rate ◽  
Doubling Time ◽  
The United States ◽  
Annual Growth ◽  
Scientometric Analysis ◽  
Annual Growth Rate ◽  
Authorship Pattern ◽  
Relative Growth ◽  
Compound Annual Growth Rate ◽  
Scopus Database

The present study aims to analysis authorship pattern and collaboration coefficient of library professional’s competency publications research from 1999-2018. The data has been downloaded by Scopus database. A total number of published articles during the period of study was 433 in the particular database on the topic of ‘professional’s competency’. The study examine various scientometric parameter such as authorship pattern, year wise distribution of publication, determine the annual growth rate and compound annual growth rate of publication, relative growth rate and doubling time of publication and so many. After the analysis, it is found that the highest 11.78% of an article published in the year 2015. The highest growth rate in 2000 and the lowest in 1999. The United States published highest 174 article and secured first place in top five countries wish distribution of the publication. Majority of the article is published by single authors is 171 articles during the period of study.

Sign in / Sign up

Export Citation Format

Share Document