Location of intracranial aneurysms is the main factor associated with rupture in the ICAN population. Issue 2 (23rd October 2020)

• Record Type: Journal Article
• Authors: Rousseau, Olivia; Karakachoff, Matilde; Gaignard, Alban; Bellanger, Lise; Bijlenga, Philippe; Constant Dit Beaufils, Pacôme; L'Allinec, Vincent; Levrier, Olivier; Aguettaz, Pierre; Desilles, Jean-Philippe; Michelozzi, Caterina; Marnat, Gaultier; Vion, Anne-Clémence; Loirand, Gervaise; Desal, Hubert; Redon, Richard; Gourraud, Pierre-Antoine; Bourcier, Romain
• Other Names: author non-byline.; Desal Hubert author non-byline.; Bourcier Romain author non-byline.; Redon Richard author non-byline.; Loirand Gervaise author non-byline.; Schott Jean-Jacques author non-byline.; Chatel Stéphanie author non-byline.; Bourcereau Emmanuelle author non-byline.; Dina Christian author non-byline.; Simonet Floriane author non-byline.; Charpentier Eric author non-byline.; Baron Estelle author non-byline.; Bonnaud Stéphanie author non-byline.; Daumas-Duport Benjamin author non-byline.; Isidor Bertrand author non-byline.; Connault Jérôme author non-byline.; Lebranchu Pierre author non-byline.; Rimbert Antoine author non-byline.; Tourneau Thierry Le author non-byline.; Papagiannaki Chrisanthi author non-byline.; Piotin Michel author non-byline.; Redjem Hocine author non-byline.; Mazighi Mikael author non-byline.; Desilles Jean Philippe author non-byline.; Naggara Olivier author non-byline.; Trystram Denis author non-byline.; Edjlali-Goujon Myriam author non-byline.; Boulouis Grégoire author non-byline.; Rodriguez Christine author non-byline.; Hassen Waghi Ben author non-byline.; Saleme Suzanna author non-byline.; Mounayer Charbel author non-byline.; Rouchaud Aymeric author non-byline.; Levrier Olivier author non-byline.; Aguettaz Pierre author non-byline.; Combaz Xavier author non-byline.; Pasco Anne author non-byline.; l'Allinec Vincent author non-byline.; Bintner Marc author non-byline.; Molho Marc author non-byline.; Gauthier Pascale author non-byline.; Chivot Cyril author non-byline.; Costalat Vincent author non-byline.; Darganzil Cyril author non-byline.; Bonafé Alain author non-byline.; Januel Anne Christine author non-byline.; Michelozzi Caterina author non-byline.; Cognard Christophe author non-byline.; Bonneville Fabrice author non-byline.; Tall Philippe author non-byline.; Darcourt Jean author non-byline.; Biondi Alessandra author non-byline.; Iosif Cristina author non-byline.; Ferre Jean Christophe author non-byline.; Gauvrit Jean Yves author non-byline.; Eugene François author non-byline.; Raoult Hélène author non-byline.; Gentric Jean Christophe author non-byline.; Ognard Julien author non-byline.; Anxionnat René author non-byline.; Gory Benjamin author non-byline.; Bracard Serge author non-byline.; Derelle Anne Laure author non-byline.; Tonnelet Romain author non-byline.; Spelle Laurent author non-byline.; Ikka Léon author non-byline.; Ozanne Augustin author non-byline.; Gallas Sophie author non-byline.; Caroff Jildaz author non-byline.; Achour Nidal Ben author non-byline.; Moret Jacques author non-byline.; Chabert Emmanuel author non-byline.; Berge Jérôme author non-byline.; Marnat Gaultier author non-byline.; Barreau Xavier author non-byline.; Gariel Florent author non-byline.; Clarencon Frédéric author non-byline.; Shotar Eimad author non-byline.; Aggour Mohammed author non-byline.; Ricolfi Frédéric author non-byline.; Chavent Adrien author non-byline.; Thouant Pierre author non-byline.; Lebidinsky Pablo author non-byline.; Lemogne Brivael author non-byline.; Herbreteau Denis author non-byline.; Bibi Richard author non-byline.; Janot Kevin author non-byline.; Pierot Laurent author non-byline.; Soize Sébastien author non-byline.; Labeyrie Marc Antoine author non-byline.; Vandendries Christophe author non-byline.; Houdart Emmanuel author non-byline.; Kazemi Appoline author non-byline.; Leclerc Xavier author non-byline.; Pruvo Jean Pierre author non-byline.; Bricout Nicolas author non-byline.; Velasco Stéphane author non-byline.; Boucebci Samy author non-byline.;
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 92:Issue 2(2021)
• Page Start: 122
• Page End: 128
• Publication Date: 2020-10-23
• Subjects: intracranial aneurysm -- rupture -- risks -- location -- machine learning -- decision trees; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2020-324371
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background and purpose: The ever-growing availability of imaging led to increasing incidentally discovered unruptured intracranial aneurysms (UIAs). We leveraged machine-learning techniques and advanced statistical methods to provide new insights into rupture intracranial aneurysm (RIA) risks. Methods: We analysed the characteristics of 2505 patients with intracranial aneurysms (IA) discovered between 2016 and 2019. Baseline characteristics, familial history of IA, tobacco and alcohol consumption, pharmacological treatments before the IA diagnosis, cardiovascular risk factors and comorbidities, headaches, allergy and atopy, IA location, absolute IA size and adjusted size ratio (aSR) were analysed with a multivariable logistic regression (MLR) model. A random forest (RF) method globally assessed the risk factors and evaluated the predictive capacity of a multivariate model. Results: Among 994 patients with RIA (39.7%) and 1511 patients with UIA (60.3 %), the MLR showed that IA location appeared to be the most significant factor associated with RIA (OR, 95% CI: internal carotid artery, reference; middle cerebral artery, 2.72, 2.02–3.58; anterior cerebral artery, 4.99, 3.61–6.92; posterior circulation arteries, 6.05, 4.41–8.33). Size and aSR were not significant factors associated with RIA in the MLR model and antiplatelet-treatment intake patients were less likely to have RIA (OR: 0.74; 95% CI: 0.55–0.98). IA location, age, following by aSR were the best predictors of RIA using the RF model. Conclusions: The location of IA is the most consistent parameter associated with RIA. The use of 'artificial intelligence' RF helps to re-evaluate the contribution and selection of each risk factor in the multivariate model.