TY - JOUR
T1 - Intracranial Aneurysms in Patients with Marfan Syndrome
T2 - A Multicenter Propensity-Matched Analysis
AU - Domingo, Ricardo A.
AU - Perez-Vega, Carlos
AU - Tripathi, Shashwat
AU - Santos, Jaime Martínez
AU - Ramos-Fresnedo, Andres
AU - Erben, Young M.
AU - Freeman, William D.
AU - Sandhu, Sukhwinder S.
AU - Huynh, Thien
AU - Williams, Lindsy
AU - Bendok, Bernard R.
AU - Brinjikji, Waleed
AU - Tawk, Rabih G.
AU - Fox, W. Christopher
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/11
Y1 - 2021/11
N2 - Objective: We sought to identify risk factors for intracranial aneurysms (IAs) in Marfan syndrome (MFS) patients and to describe their characteristics. Methods: Patients with confirmed MFS and vessel-dedicated brain imaging from January 1, 1980–December 1, 2020 were categorized according to the presence (IA) or absence (NIA) of IAs. Unmatched logistic regression analysis and propensity score matching were used for comparison. Results: We included 159 patients, of whom 18 (11.3%) patients had radiographic diagnosis of IAs. Three patients (16.7%) had multiple lesions for a total of 24 IAs. One patient (5.5%) had de novo IA formation. Four patients (22.2%) underwent treatment: Two (11.1%) had open surgical clipping for ruptured aneurysms, and two (11.1%) patients had endovascular embolization for growth. In the unmatched analysis, current tobacco smoker status (odds ratio [OR]: 4.20; confidence interval [CI]: 1.11–15.6; P = 0.027) and history of coronary artery disease (CAD) (OR: 5.79; CI 1.76–20.2; P = 0.004) increased the odds for IA. Propensity score matching yielded 18 IA and 18 NIA patients matched for age, gender, race, prior stroke, and family history of aneurysms. History of CAD (IA = 11 [61.1%] vs. NIA = 4 (22.2%), P = 0.043) and current smoker status (IA = 6 [33.3%] vs. NIA = 0 (0%), P < 0.01) were significantly higher in the IA cohort. Body mass index (P = 0.622), diabetes (P = 0.180), hypertension (P = 0.732), prior stroke (P = 1.00), family history (P = 0.732), alcohol (P = 0.314), recreational drugs (P = 1.00), and other aneurysms (P = 0.585) were not statistically significant. Conclusions: Prevalence of IAs in our series of MFS patients was 11.3%, and de novo formation was 5.5%. MFS patients with a history of CAD and current smoker status had an increased risk of IA. Neurovascular radiographic screening should be considered in all patients with MFS, particularly in patients who smoke or have a history of heart disease.
AB - Objective: We sought to identify risk factors for intracranial aneurysms (IAs) in Marfan syndrome (MFS) patients and to describe their characteristics. Methods: Patients with confirmed MFS and vessel-dedicated brain imaging from January 1, 1980–December 1, 2020 were categorized according to the presence (IA) or absence (NIA) of IAs. Unmatched logistic regression analysis and propensity score matching were used for comparison. Results: We included 159 patients, of whom 18 (11.3%) patients had radiographic diagnosis of IAs. Three patients (16.7%) had multiple lesions for a total of 24 IAs. One patient (5.5%) had de novo IA formation. Four patients (22.2%) underwent treatment: Two (11.1%) had open surgical clipping for ruptured aneurysms, and two (11.1%) patients had endovascular embolization for growth. In the unmatched analysis, current tobacco smoker status (odds ratio [OR]: 4.20; confidence interval [CI]: 1.11–15.6; P = 0.027) and history of coronary artery disease (CAD) (OR: 5.79; CI 1.76–20.2; P = 0.004) increased the odds for IA. Propensity score matching yielded 18 IA and 18 NIA patients matched for age, gender, race, prior stroke, and family history of aneurysms. History of CAD (IA = 11 [61.1%] vs. NIA = 4 (22.2%), P = 0.043) and current smoker status (IA = 6 [33.3%] vs. NIA = 0 (0%), P < 0.01) were significantly higher in the IA cohort. Body mass index (P = 0.622), diabetes (P = 0.180), hypertension (P = 0.732), prior stroke (P = 1.00), family history (P = 0.732), alcohol (P = 0.314), recreational drugs (P = 1.00), and other aneurysms (P = 0.585) were not statistically significant. Conclusions: Prevalence of IAs in our series of MFS patients was 11.3%, and de novo formation was 5.5%. MFS patients with a history of CAD and current smoker status had an increased risk of IA. Neurovascular radiographic screening should be considered in all patients with MFS, particularly in patients who smoke or have a history of heart disease.
KW - Aneurysm
KW - Endovascular
KW - Hemorrhage
KW - Intracranial
KW - Marfan
KW - Smoking
KW - Surgery
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U2 - 10.1016/j.wneu.2021.08.065
DO - 10.1016/j.wneu.2021.08.065
M3 - Article
C2 - 34425290
AN - SCOPUS:85114670223
SN - 1878-8750
VL - 155
SP - e345-e352
JO - World neurosurgery
JF - World neurosurgery
ER -