| Title: |
Aneurysm Wall Enhancement and Probability of Instability in Unruptured Intracranial Aneurysms:A Long-Term Follow-Up Study |
| Authors: |
van der Kamp, Laura T; Kamphuis, Maarten J; Naggara,Olivier; Le Tat,Thomas; Rinkel, Gabriel J E; de Kort,Gérard A P; van Eijk, Ruben P A; Hendrikse, Jeroen; van der Schaaf, Irene C; Vergouwen, Mervyn D I; Brain; Circulatory Health; Projectafdeling CVZ; Onderzoek Beeld; Cancer; Neurologen; Projectafdeling ALS; Divisie Beeld & Oncologie; MS Radiologie |
| Publication Year: |
2026 |
| Subject Terms: |
Journal Article |
| Description: |
Objective: Aneurysm wall enhancement (AWE) may predict aneurysm growth and rupture in the short-term, but there is a lack of long-term follow-up studies. We aimed to determine whether unruptured intracranial aneurysms (UIAs) with AWE have a higher probability of aneurysm instability during long-term follow-up compared with those without AWE. Methods: For this longitudinal cohort study, we obtained individual patient data from two international cohorts. We included patients with ≥ 1 untreated UIA who underwent gadolinium-enhanced aneurysm wall imaging and magnetic resonance angiography (MRA) between 2012 and 2016, and had follow-up imaging and/or had a rupture during follow-up. The outcome was aneurysm instability, defined as time to growth, morphological change, or rupture during follow-up. We calculated the 7.5-year probability of aneurysm instability with 95% confidence interval (CI) with the Kaplan–Meier estimator. We used Cox regression survival analysis to calculate the crude hazard ratio (HR) with corresponding 95% CI of AWE for aneurysm instability, and the HR adjusted for age and aneurysm size at baseline. Results: We included 198 patients (median age = 58 years, interquartile range = 50–68, 139 women, 70%) with 224 aneurysms. Aneurysm instability was observed in 15 of 72 aneurysms (21%) with AWE and 13 of 152 aneurysms (9%) without AWE during a median follow-up duration of 6.8 years (IQR = 3.3–7.9). The 7.5-year probability of instability was 29.2% (95% CI = 14.5%–41.3%) in aneurysms with AWE and 9.3% (95% CI = 2.9%–15.3%) in aneurysms without AWE (crude HR = 4.29, 95% CI = 1.90–9.72, adjusted HR = 5.06, 95% CI = 2.13–12.02). Interpretation: UIAs with AWE have a higher probability of 7.5-year aneurysm instability compared with those without AWE. ANN NEUROL 2026;99:863–870. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
0364-5134 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/483754 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/483754 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.64D9AE94 |
| Database: |
BASE |