Daan Backes1, Gabriel J E Rinkel2, Jacoba P Greving2, Birgitta K Velthuis2, Yuichi Murayama2, Hiroyuki Takao2, Toshihiro Ishibashi2, Michiya Igase2, Karel G terBrugge2, Ronit Agid2, Juha E Jääskeläinen2, Antti E Lindgren2, Timo Koivisto2, Mikael von Und Zu Fraunberg2, Shunji Matsubara2, Junta Moroi2, George K C Wong2, Jill M Abrigo2, Keiji Igase2, Katsumi Matsumoto2, Marieke J H Wermer2, Marianne A A van Walderveen2, Ale Algra2, Mervyn D I Vergouwen2. 1. From the Department of Neurology and Neurosurgery (D.B., G.J.E.R., A.A., M.D.I.V.), Brain Centre Rudolf Magnus, Julius Centre for Health Sciences and Primary Care (J.P.G., A.A.), and Department of Radiology (B.K.V.), University Medical Centre Utrecht, the Netherlands; Division of Endovascular Neurosurgery (Y.M., H.T., T.I.), Department of Neurosurgery, Jikei University School of Medicine, Tokyo; Department of Geriatrics and Neurology (M.I.), Ehime University School of Medicine, Toon City, Japan; Division of Neuroradiology (K.G.t.B., R.A.), Department of Medical Imaging, Toronto Western Hospital, Ontario, Canada; Department of Neurosurgery (J.E.J., A.E.L., T.K., M.v.u.z.F.), NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland; Department of Neurosurgery (S.M.), Kawasaki Medical School Hospital, Kurashiki City; Department of Surgical Neurology (J.M.), Research Institute for Brain and Blood Vessels, Akita, Japan; Division of Neurosurgery and Department of Imaging and Interventional Radiology (G.K.C.W., J.M.A.), Prince of Wales Hospital, The Chinese University of Hong Kong, China; Department of Neurosurgery (K.I.), Washokai Sadamoto Hospital, Matsuyama, Ehime; Department of Neurosurgery (K.M.), Iseikai Hospital, Osaka City, Japan; and Departments of Neurology (M.J.H.W.) and Radiology (M.A.A.v.W.), Leiden University Medical Centre, the Netherlands. D.Backes-2@umcutrecht.nl. 2. From the Department of Neurology and Neurosurgery (D.B., G.J.E.R., A.A., M.D.I.V.), Brain Centre Rudolf Magnus, Julius Centre for Health Sciences and Primary Care (J.P.G., A.A.), and Department of Radiology (B.K.V.), University Medical Centre Utrecht, the Netherlands; Division of Endovascular Neurosurgery (Y.M., H.T., T.I.), Department of Neurosurgery, Jikei University School of Medicine, Tokyo; Department of Geriatrics and Neurology (M.I.), Ehime University School of Medicine, Toon City, Japan; Division of Neuroradiology (K.G.t.B., R.A.), Department of Medical Imaging, Toronto Western Hospital, Ontario, Canada; Department of Neurosurgery (J.E.J., A.E.L., T.K., M.v.u.z.F.), NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland; Department of Neurosurgery (S.M.), Kawasaki Medical School Hospital, Kurashiki City; Department of Surgical Neurology (J.M.), Research Institute for Brain and Blood Vessels, Akita, Japan; Division of Neurosurgery and Department of Imaging and Interventional Radiology (G.K.C.W., J.M.A.), Prince of Wales Hospital, The Chinese University of Hong Kong, China; Department of Neurosurgery (K.I.), Washokai Sadamoto Hospital, Matsuyama, Ehime; Department of Neurosurgery (K.M.), Iseikai Hospital, Osaka City, Japan; and Departments of Neurology (M.J.H.W.) and Radiology (M.A.A.v.W.), Leiden University Medical Centre, the Netherlands.
Abstract
OBJECTIVE: To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth. METHODS: From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1,507 patients with 1,909 unruptured intracranial aneurysms and used aneurysm growth as outcome. With aneurysm-based multivariable Cox regression analysis, we determined predictors for aneurysm growth, which were presented as a risk score to calculate 3-year and 5-year risks for aneurysm growth by risk factor status. RESULTS: Aneurysm growth occurred in 257 patients (17%) and 267 aneurysms (14%) during 5,782 patient-years of follow-up. Predictors for aneurysm growth were earlier subarachnoid hemorrhage, location of the aneurysm, age >60 years, population, size of the aneurysm, and shape of the aneurysm (ELAPSS). The 3-year growth risk ranged from <5% to >42% and the 5-year growth risk from <9% to >60%, depending on the risk factor status. CONCLUSIONS: The ELAPSS score consists of 6 easily retrievable predictors and can help physicians in decision making on the need for and timing of follow-up imaging in patients with unruptured intracranial aneurysms.
OBJECTIVE: To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth. METHODS: From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1,507 patients with 1,909 unruptured intracranial aneurysms and used aneurysm growth as outcome. With aneurysm-based multivariable Cox regression analysis, we determined predictors for aneurysm growth, which were presented as a risk score to calculate 3-year and 5-year risks for aneurysm growth by risk factor status. RESULTS:Aneurysm growth occurred in 257 patients (17%) and 267 aneurysms (14%) during 5,782 patient-years of follow-up. Predictors for aneurysm growth were earlier subarachnoid hemorrhage, location of the aneurysm, age >60 years, population, size of the aneurysm, and shape of the aneurysm (ELAPSS). The 3-year growth risk ranged from <5% to >42% and the 5-year growth risk from <9% to >60%, depending on the risk factor status. CONCLUSIONS: The ELAPSS score consists of 6 easily retrievable predictors and can help physicians in decision making on the need for and timing of follow-up imaging in patients with unruptured intracranial aneurysms.
Authors: M D I Vergouwen; D Backes; I C van der Schaaf; J Hendrikse; R Kleinloog; A Algra; G J E Rinkel Journal: AJNR Am J Neuroradiol Date: 2019-06-20 Impact factor: 3.825
Authors: Felicitas J Detmer; Sara Hadad; Bong Jae Chung; Fernando Mut; Martin Slawski; Norman Juchler; Vartan Kurtcuoglu; Sven Hirsch; Philippe Bijlenga; Yuya Uchiyama; Soichiro Fujimura; Makoto Yamamoto; Yuichi Murayama; Hiroyuki Takao; Timo Koivisto; Juhana Frösen; Juan R Cebral Journal: Neurosurg Focus Date: 2019-07-01 Impact factor: 4.047
Authors: Felicitas J Detmer; Bong Jae Chung; Fernando Mut; Michael Pritz; Martin Slawski; Farid Hamzei-Sichani; David Kallmes; Christopher Putman; Carlos Jimenez; Juan R Cebral Journal: Acta Neurochir (Wien) Date: 2018-06-20 Impact factor: 2.216
Authors: Felicitas J Detmer; Bong Jae Chung; Carlos Jimenez; Farid Hamzei-Sichani; David Kallmes; Christopher Putman; Juan R Cebral Journal: Neuroradiology Date: 2018-11-19 Impact factor: 2.804