Sex Differences In The Prevalence Of Intracranial Aneurysms In Patients With Ascending Thoracic Aneurysms A Multi-center Experience
Camila Franco Mesa, MD1, Young Erben1, Guiseppe Lanzino2, Susana Fortich1, Gian P. Carames1, Kevin M. Barrett1, Alberto Pochettino2, Amy R. Theiler2, Coleen T. Ball1, Si M. Pham1, Rabih Tawk1, William C. Fox1, Thien Huynh1, David A. Miller1, Sukhwinder S.J Sandhu1, Thomas G. Brott1, James F. Meschia1.
1Mayo Clinic, Jacksonville, FL, USA, 2Mayo Clinic, Rochester, MN, USA.
OBJECTIVES: Our previous study suggests a co-prevalence of intracranial aneurysms (IA) in patients with infrarenal abdominal aortic aneurysms (AAA). We reviewed our multi-center experience in the detection/treatment of IAs in patients with ascending thoracic aortic aneurysms (ATAA) relative to patients without ATAA.
METHODS: We reviewed surgical cases of ATAA repaired at three sites from January 1998 to December 2018. Those with head imaging were selected and these individuals were randomly matched with a control group of patients who had head imaging without an ATAA in a 1:1 ratio by age, sex, smoking history and head imaging characteristics. RESULTS: We reviewed 2176 ATAA repairs. 74% were men. Head imaging was available in 298 (13.7%) patients. 19 patients were found to have 22 IAs for a prevalence of 6.4%. Mean size of IA was 4.6±3.3mm; mean age at IA detection, 63.4±12.1 years. IA was present on head imaging in 4.7% of male and 12.5% of female patients. 14(73.7%) were men. OR of having IA in female versus male patients is 2.90, 95% CI[1.08-7.50], p=0.029. All were diagnosed before ATAA repair. Time from IA diagnosis to AAA repair was 17.9±17.6 years. In the matched group of patients who had head imaging without ascending aortic aneurysms, the rate of IA is 5.0%. IA was detected in 3.8% of males and 9.4% of female patients for an OR of 2.59, 95% CI[0.84-7.47], p=0.083. Association within our study and matched groups, the OR of developing an IA with and without ATAAA was not statistically significant 1.29, 95% CI[0.64-2.59], p=0.48. There was also no evidence of sex differences in the association of ATAA with IA (interaction p=0.88). The OR for the association of ATAA with IA was 1.33, 95% CI[0.46-3.84], p=0.59 in females and 1.25, 95% CI[0.49-3.17], p=0.64 in males. CONCLUSIONS: Our study found that IA was present in 6.4% of patients with ATAA who had head imaging. The odds of IA were 1.29 times higher than a matched cohort of patients who had head imaging without ATAA; but this was not statistically significant. We found that the odds of IA was more than two times higher in females than males for both those with ATAA(OR=2.90) and those without ATAA(OR=2.59); however, it only reached statistically significance in those with ATAA.
Back to 2022 ePosters