Intracranial Aneurysm Classifier Using Phenotypic Factors: An International Pooled Analysis

Sandrine Morel , Isabel Hostettler , Georg Spinner , Romain Bourcier , Joanna Pera , Torstein Meling , Varinder Alg , Henry Houlden , Mark Bakker , Femke Van’t Hof , Gabriel Rinkel , Tatiana Foroud , Dongbing Lai , Charles Moomaw , Bradford Worrall , Jildaz Caroff , Pacôme Constant-Dits-Beaufils , Matilde Karakachoff , Antoine Rimbert (1) , Aymeric Rouchaud , Emilia Gaal-Paavola , Hanna Kaukovalta , Riku Kivisaari , Aki Laakso , Behnam Rezai Jahromi , Riikka Tulamo , Christoph Friedrich , Jerome Dauvillier , Sven Hirsch , Nathalie Isidor , Zolt Kulcsàr , Karl Lövblad , Olivier Martin , Paolo Machi , Vitor Mendes Pereira , Daniel Rüfenacht , Karl Schaller , Sabine Schilling , Agnieszka Slowik , Juha Jaaskelainen , Mikael von Und zu Fraunberg , Jordi Jiménez-Conde , Elisa Cuadrado-Godia , Carolina Soriano-Tárraga , Iona Millwood , Robin Walters , Helen Kim , Richard Redon , Nerissa Ko , Guy Rouleau , Antti Lindgren , Mika Niemelä , Hubert Desal , Daniel Woo , Joseph Broderick , David Werring , Ynte Ruigrok , Philippe Bijlenga

1 Nantes Université, CHU Nantes, CNRS, INSERM, l’institut du thorax, F-44000 Nantes, France

Intracranial aneurysms (IAs) are usually asymptomatic with a low risk of rupture, but consequences of aneurysmal subarachnoid hemorrhage (aSAH) are severe. Identifying IAs at risk of rupture has important clinical and socio-economic consequences. The goal of this study was to assess the effect of patient and IA characteristics on the likelihood of IA being diagnosed incidentally versus ruptured. Patients were recruited at 21 international centers. Seven phenotypic patient characteristics and three IA characteristics were recorded. The analyzed cohort included 7992 patients. Multivariate analysis demonstrated that: (1) IA location is the strongest factor associated with IA rupture status at diagnosis; (2) Risk factor awareness (hypertension, smoking) increases the likelihood of being diagnosed with unruptured IA; (3) Patients with ruptured IAs in high-risk locations tend to be older, and their IAs are smaller; (4) Smokers with ruptured IAs tend to be younger, and their IAs are larger; (5) Female patients with ruptured IAs tend to be older, and their IAs are smaller; (6) IA size and age at rupture correlate. The assessment of associations regarding patient and IA characteristics with IA rupture allows us to refine IA disease models and provide data to develop risk instruments for clinicians to support personalized decision-making.

Domains: Life Sciences [q-bio]

Sandrine Morel, Isabel Hostettler, Georg Spinner, Romain Bourcier, Joanna Pera, et al.. Intracranial Aneurysm Classifier Using Phenotypic Factors: An International Pooled Analysis. Journal of Personalized Medicine, 2022, 12 (9), pp.1410. ⟨10.3390/jpm12091410⟩. ⟨hal-04060055⟩