Intracranial aneurysm location: potential influencing factor in ruptures with internal carotid artery occlusion.

Abstract

Background and purpose: Intracranial aneurysms combined with spontaneous internal carotid artery occlusion (ICAO) are a rare and serious vascular disorder. Currently, there is only limited information available on the clinical characteristics of these patients and the risk factors for aneurysm rupture. Our objective is to describe the clinical features of these patients and predict the risk factors for the rupture of unruptured intracranial aneurysms (UIAs) combined with ICAO.

Methods: We retrospectively analyzed cases of intracranial aneurysms with concurrent spontaneous ICAO from the Chinese Multicenter Aneurysm Database(CMAD). We collected population demographic characteristics and clinical data using a standardized case questionnaire from CMAD. Binary logistic regression analysis was used to identify risk factors for rupture of UIA associated with combined ICAO.

Results: We identified 93 patients with intracranial aneurysms combined with ICAO, including 38 females and 55 males, with an average age of 60.7 ± 9.5 years (ranging from 32 to 79 years old). Among those with ICAO, 52 had ruptured intracranial aneurysms (RIAs) and 41 had UIAs. Specifically, there were 81 cases of unilateral ICAO, with 16 aneurysms located on the same side as the ICAO, 22 in the midline (AcomA, Basilar tip), and 43 on the opposite side of the ICAO; 12 cases were bilateral ICAO. Binary logistic regression analysis indicated that risk factors associated with the rupture of UIAs with ICAO included bilateral internal carotid artery occlusion and aneurysms in the posterior circulation. Furthermore, multivariate analysis showed that posterior circulation aneurysms are an independent risk factor for the rupture of UIAs with ICAO.

Conclusion: We have described and analyzed the clinical characteristics and risk factors influencing the rupture of intracranial aneurysms in patients with ICAO. The study found that the location of the aneurysm is an important risk factor for the rupture of UIAs combined with ICAO.