Prevalence of Intracranial Aneurysms in Patients with Aortic Dissection

Jung, Woo Sang; Kim, J.H.; Ahn, Sung Jun; Song, Suk-Won; Kim, B.M.; Seo, Kwon‐Duk; Suh, Sang Hyun

doi:10.3174/ajnr.a5359

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…Three studies investigated the proportion of patients with aortic aneurysm or BAV in patients suffered from IA. [19][20][21] Ten studies reported a prevalence of IA in patients with aortopathy: two studies were in patients with BAV; 10,13 three studies considered patients with CoA; 9,11,12 three studies were conducted in patients with aortic aneurysm; 5,7,8 one study investigated aortic dissection; 3 and one study examined both aortic aneurysm and aortic dissection. 6 Seven studies were from the USA, and three studies from South Korea.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Seven risk factors ( Supplementary Figures 1-7) were reported in three or more studies: female gender, 3,6,7,9-13 smoking, 3,6,7,[10][11][12][13] hypertension, 3,6,7,10-13 age, 6,9,11,13 diabetes, 3,6,7,13 hyperlipidemia, 3,6,7 and the overlapping of two aortic diseases. 7,9,[11][12][13] Pooled analyses yielded effect estimates for the effect of risk factors on the increased prevalence of IAs ( Figure 3…”

Section: Risk Factorsmentioning

confidence: 99%

“…Due to the advancing availability and quality of brain imaging techniques (e.g., magnetic resonance imaging scanning), the early diagnosis of IA in adults is promising, 2 especially in high-risk patients with selected conditions. 3 The guidelines for unruptured IAs 4 indicate a higher prevalence of IA in patients with bicuspid aortic valve (BAV) or coarctation of the aorta (CoA). A propositional screening is suggested among patients with either of the two diseases.…”

Section: Introductionmentioning

confidence: 99%

“…A propositional screening is suggested among patients with either of the two diseases. Recent studies 3,[5][6][7][8] propose that aortic aneurysm and aortic dissection are also involved with an increased risk of IA. BAV, CoA, aortic aneurysm, and aortic dissection are four aortic diseases which attack aortic valve or segmentation of the aorta with distinct pathological manifestations.…”

Section: Introductionmentioning

confidence: 99%

“…Both genetic factors and excessive hemodynamic stress caused by hypertension may play an essential role in the pathogenesis of the two diseases. 3 According to previous epidemiological studies, 3,[5][6][7][8][9][10][11][12][13] the disease status of aortopathy might be used to predict the presence of IA.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses

Xia

Jiang

et al. 2020

J Stroke

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Background and Purpose Patients with aortic disease might have an increased risk of intracranial aneurysm (IA). We conducted this research to assess the prevalence of IA in patients with aortopathy, considering the impact of gender, age, and cardiovascular risk factors.Methods We searched PubMed and Scopus from inception to August 2019 for epidemiological studies reporting the prevalence of IA in patients with aortopathy. Random-effect meta-analyses were performed to calculate the overall prevalence, and the effect of risk factors on the prevalence was also evaluated. Anatomical location of IAs in patients suffered from distinct aortic disease was extracted and further analyzed.Results Thirteen cross-sectional studies involving 4,041 participants were included in this systematic review. We reported an estimated prevalence of 12% (95% confidence interval [CI], 9% to 14%) of IA in patients with aortopathy. The pooled prevalence of IA in patients with bicuspid aortic valve, coarctation of the aorta, aortic aneurysm, and aortic dissection was 8% (95% CI, 6% to 10%), 10% (95% CI, 7% to 14%), 12% (95% CI, 9% to 15%), and 23% (95% CI, 12% to 34%), respectively. Gender (female) and smoking are risk factors related to an increased risk of IA. The anatomical distribution of IAs was heterogeneously between participants with different aortic disease.Conclusions According to current epidemiological evidence, the prevalence of IA in patients with aortic disease is quadrupled compared to that in the general population, which suggests that an early IA screening should be considered among patients with aortic disease for timely diagnosis and treatment of IA.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses

Xia

Jiang

et al. 2020

J Stroke

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Postoperative Stroke After Type A Aortic Dissection Repair: Hemorrhage Versus Ischemia

Lin

Lee

et al. 2021

World j. surg.

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Background Postoperative stroke is a severe and potentially disabling complication following surgical intervention for acute type A aortic dissection (ATAAD). This retrospective study aims to compare the early and late outcomes between patients who had hemorrhagic and ischemic stroke after undergoing ATAAD repair surgery. Methods Between January 2007 and June 2020, a total of 685 consecutive patients underwent ATAAD repair at our institution. Patients who had a preoperative stroke or were unconscious at presentation were excluded from this study. Of the 656 included for analysis, 102 (15.5%) patients had a postoperative stroke confirmed by computed tomography angiography. The strokes were classified into the ischemia group (n = 83, 12.7%) and hemorrhage group (n = 19, 2.9%). Clinical features, surgical information, postoperative complications, modified Rankin Scale (mRS) scores after discharge, and 5-year cumulative survival rates were compared. Results Demographics, comorbidities, and presentations of ATAAD were similar between the two groups, except a higher rate of preoperative antithrombotic medication was found in the hemorrhage group. The hemorrhage group was associated with a higher complexity of aortic arch replacement, longer cardiopulmonary bypass, and aortic clamping times than the ischemia group. A higher in-hospital mortality rate (42.1% versus 20.5%; p = 0.048) and a higher median mRS score at the 3-month follow-up after discharge (6[3-6] versus 4[2-6]; p = 0.027) were found in the hemorrhage group. The hemorrhage group showed a lower 5-year cumulative survival rate (23.4% versus 57.8%; p = 0.003) compared with the ischemia group. Conclusions Postoperative hemorrhagic stroke was associated with poorer neurological outcomes and lower survival rates than those with ischemic stroke. Patients who have complex arch replacement, long cardiopulmonary bypass and aortic clamping times are at risk for postoperative hemorrhagic stroke and should have intensive neurological surveillance for early diagnosis and treatment after ATAAD repair surgery.

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Exome sequencing in 38 patients with intracranial aneurysms and subarachnoid hemorrhage

et al. 2020

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Objective Genetic risk factors for unruptured intracranial aneurysms (UIA) and aneurysmal subarachnoid hemorrhage (aSAH) are poorly understood. We aimed to verify recently reported risk genes and to identify novel sequence variants involved in the etiology of UIA/aSAH. Methods We performed exome sequencing (ES) in 35 unrelated individuals and 3 family members, each with a history of UIA and/or aSAH. We searched for sequence variants with minor allele frequency (MAF) ≤ 5% in the reported risk genes ADAMTS15, ANGPTL6, ARHGEF17, LOXL2, PCNT, RNF213, THSD1 and TMEM132B. To identify novel putative risk genes we looked for unknown (MAF = 0) variants shared by the three relatives. Results We identified 20 variants with MAF ≤ 5% in 18 individuals: 9 variants in PCNT (9 patients), 4 in RNF213 (3 patients), 3 in THSD1 (6 patients), 2 in ANGPTL6 (3 patients), 1 in ADAMTS15 (1 patient) and 1 in TMEM132B (1 patient). In the affected family, prioritization of shared sequence variants yielded five novel putative risk genes. Based on predicted pathogenicity of identified variants, population genetics data and a high functional relevance for vascular biology, EDIL3 was selected as top candidate and screened in additional 37 individuals with UIA and/or aSAH: a further very rare EDIL3 sequence variant in two unrelated sporadic patients was identified. Conclusions Our data support a role of sequence variants in PCNT, RNF213 and THSD1 as susceptibility factors for cerebrovascular disease. The documented function in vascular wall integrity, the crucial localization of affected amino acids and gene/variant association tests suggest EDIL3 as a further valid candidate disease gene for UIA/aSAH.

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Prevalence of Intracranial Aneurysms in Patients with Aortic Dissection

Cited by 14 publications

References 21 publications

Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses

Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses

Postoperative Stroke After Type A Aortic Dissection Repair: Hemorrhage Versus Ischemia

Exome sequencing in 38 patients with intracranial aneurysms and subarachnoid hemorrhage

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