Aspirin and growth, rupture of unruptured intracranial aneurysms: A systematic review and meta-analysis

Guo, Yu; Guo, Xin-Mei; Zhao, Kai; Yang, Mei

doi:10.1016/j.clineuro.2021.106949

Cited by 4 publications

(5 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the context of aspirin administration in patients with intracranial aneurysms (IAs), existing evidence suggests that inflammation plays a critical role in the structural change of the aneurysm wall and its subsequent rupture [17]. Several observational studies have linked the use of nonsteroidal antiinflammatory drugs (NSAIDs) with a decrease in the growth rate of IA and a lower risk of developing Aneurysmal Subarachnoid Hemorrhage (aSAH) [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Haemorrhagic Complications After Microsurgical Treatment for Intracranial Aneurysms Under Acetylsalicylic Acid: An Impact Analysis

Konovalov,

Grebenev,

Artemyev

et al. 2024

Cureus

View full text Add to dashboard Cite

Background: Patients with intracranial aneurysms often have comorbidities that require them to take acetylsalicylic acid (ASA). In recent years, many patients with aneurysms have been prescribed ASA to prevent aneurysm enlargement. ASA is also prescribed to patients with intracranial aneurysms in preparation for surgical revascularization. Methods: From 2016 to 2021, 64 patients underwent microsurgical aneurysm clipping without revascularization, and an additional 20 patients underwent extracranial to intracranial (EC-IC) bypass. The following parameters were analysed: the frequency of hemorrhagic complications, the blood loss volume, the duration of surgery and inpatient treatment, the change in hemoglobin level (Hb), hematocrit (Ht), erythrocytes, and clinical outcomes according to the modified Rankin scale (mRS). Results: At the time of surgery, laboratory-confirmed effect of the ASA was registered in 22 patients (main group). In 42 patients, the ASA was not functional on assay (control group). Hemorrhagic complications were noted in two patients in the ASA group. In both cases, the hemorrhagic component did not exceed 15 ml in volume and did not require additional surgical interventions. Statistical analysis showed no significant differences in hemorrhagic postoperative complications. Conclusion: Taking low doses of acetylsalicylic acid during planned microsurgical clipping of cerebral aneurysms does not affect intraoperative blood loss volume, risk of postoperative hemorrhagic complications, length of stay in the hospital, or functional outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Haemorrhagic Complications After Microsurgical Treatment for Intracranial Aneurysms Under Acetylsalicylic Acid: An Impact Analysis

Konovalov,

Grebenev,

Artemyev

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…With increased ageing, the cerebral cortex degenerates, and the metabolic and regenerative abilities of cells in various tissue types and organs decrease to different degrees, while levels of neurotransmitters, such as acetylcholine and GABA is an important neurotransmitter in the central nervous system and has a regulatory role in a variety of body functions, also change the body (Gong et al., 2017 ; Guo et al., 2017 ). It has been noted that the total clinical response rate in patients aged <50 years is higher than in patients aged ≥50 years following HBO treatment (Pan, 2015 ), and that the recovery rate in patients with advanced PVS after HBO treatment is lower in patients with DOC (P. Wu et al., 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the efficacy of hyperbaric oxygen therapy for disorders of consciousness: A retrospective cohort study

Li,

Di,

Liu

et al. 2024

Brain and Behavior

View full text Add to dashboard Cite

ObjectiveTo analyze the efficacy and associated factors affecting the prognosis in patients with disturbance of consciousness after hyperbaric oxygen (HBO) treatment.MethodsA retrospective study was carried out on patients with disorders of consciousness (DOC) receiving HBO treatment from January to January 2022 in the Second Department of Rehabilitation Medicine of the Second Hospital of Hebei Medical University, China.ResultsHBO therapy improved the Glasgow Coma Scale (GCS) and Chinese Nanjing Persistent Vegetative State Scale (CNPVSS), as well as the clinical efficacy in patients with DOC. The comparison of GCS and CNPVSS scores in patients with DOC before and after HBO treatment was all statistically significant, with 325 patients (67.1%) showing effective results and 159 patients (32.9%) having unchanged outcomes. Univariate analysis indicated that there were statistically significant differences in age, HBO intervention time, HBO treatment times, pre‐treatment GCS score, and etiology and underlying diseases between the good and poor prognoses groups. Multivariate regression analysis showed that HBO intervention time ≤7 days, HBO treatment ＞ times, high GCS score before HBO treatment, and brain trauma were independent influencing factors in achieving a good prognosis for patients with DOC. Low pre‐treatment GCS scores were an independent risk factor for a poor prognosis in patients with brain trauma while being male, late HBO intervention time, fewer HBO treatment times, and low pre‐treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after a stroke. Being ≥50 years of age, late HBO intervention time, and low pre‐treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after hypoxic‐ischaemic encephalopathy.ConclusionHBO therapy can improve the GCS, CNPVSS scores and clinical efficacy in patients with DOC, and the timing of HBO intervention ≤7 days, times of HBO treatment, high pre‐treatment GCS score, and brain trauma were the independent influencing factors of good prognosis in patients with DOC.

show abstract

“…Several meta-analyses have investigated potential predictors of aneurysm rupture risk in patients with UIA ( 5 , 9 – 11 ). Greving et al ( 5 ) identified six prospective studies and found that the predictors of aneurysm rupture included age, hypertension, a history of SAH, aneurysm size, aneurysm location, and geographic region.…”

Section: Discussionmentioning

confidence: 99%

“…Shu et al ( 10 ) identified four studies reporting machine learning algorithms for rupture risk in patients with UIA and found that the diagnostic value of machine learning algorithms was excellent, with sensitivity and specificity of 84% and 78%, respectively. Guo et al ( 11 ) identified eight studies and found that aspirin plays a protective role against the risk of growth and rupture of aneurysms in patients with UIA. However, these studies did not perform exploratory analyses, and the predictors of aneurysm rupture in patients with UIA should be further explored.…”

Section: Discussionmentioning

confidence: 99%

“…Follow-up imaging could be used to monitor UIA growth, and preventive aneurysm treatment should be administered when aneurysmal growth is observed ( 7 ). Several studies have addressed the predictors of aneurysm rupture in patients with UIA; however, these studies only focused on a single factor ( 5 , 9 – 11 ). Additional risk factors should be identified to further prevent the aneurysm rupture risk.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for the rupture of intracranial aneurysms: a systematic review and meta-analysis

Ma,

Zheng,

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

PurposeThe study aimed to identify potential risk factors for aneurysm rupture by performing a systematic review and meta-analysis.Materials and methodsWe systematically searched the PubMed, Embase, and Cochrane Library electronic databases for eligible studies from their inception until June 2023.ResultsEighteen studies involving 17,069 patients with unruptured intracranial aneurysm (UIA) and 2,699 aneurysm ruptures were selected for the meta-analysis. Hyperlipidemia [odds ratio (OR): 0.47; 95% confidence interval (CI): 0.39–0.56; p < 0.001] and a family history of subarachnoid hemorrhage (SAH) (OR: 0.81; 95% CI: 0.71–0.91; p = 0.001) were associated with a reduced risk of aneurysm rupture. In contrast, a large-size aneurysm (OR: 4.49; 95% CI: 2.46–8.17; p < 0.001), ACA (OR: 3.34; 95% CI: 1.94–5.76; p < 0.001), MCA (OR: 2.16; 95% CI: 1.73–2.69; p < 0.001), and VABA (OR: 2.20; 95% CI: 1.24–3.91; p = 0.007) were associated with an increased risk of aneurysm rupture. Furthermore, the risk of aneurysm rupture was not affected by age, sex, current smoking, hypertension, diabetes mellitus, a history of SAH, and multiple aneurysms.ConclusionThis study identified the predictors of aneurysm rupture in patients with UIAs, including hyperlipidemia, a family history of SAH, a large-size aneurysm, ACA, MCA, and VABA; patients at high risk for aneurysm rupture should be carefully monitored.Systematic Review RegistrationOur study was registered in the INPLASY platform (INPLASY202360062).

show abstract

Aspirin and growth, rupture of unruptured intracranial aneurysms: A systematic review and meta-analysis

Cited by 4 publications

References 40 publications

Haemorrhagic Complications After Microsurgical Treatment for Intracranial Aneurysms Under Acetylsalicylic Acid: An Impact Analysis

Haemorrhagic Complications After Microsurgical Treatment for Intracranial Aneurysms Under Acetylsalicylic Acid: An Impact Analysis

Analysis of the efficacy of hyperbaric oxygen therapy for disorders of consciousness: A retrospective cohort study

Risk factors for the rupture of intracranial aneurysms: a systematic review and meta-analysis

Contact Info

Product

Resources

About