Incidence and risk factors for rebleeding during cerebral angiography for ruptured intracranial aneurysms

Yonsei Med J. 2015 Mar;56(2):403-9. doi: 10.3349/ymj.2015.56.2.403.

Abstract

Purpose: The purpose was to evaluate the incidence and risk factors for rebleeding during cerebral angiography in ruptured intracranial aneurysms.

Materials and methods: Among 1896 patients with ruptured intracranial aneurysms between September 2006 and December 2013, a total of 11 patients who experienced rebleeding of the ruptured aneurysms during digital subtraction angiography (DSA) were recruited in this study.

Results: There were 184 patients (9.7%) who had suffered rebleeding prior to the securing procedure. Among them, 11 patients experienced rebleeding during DSA and other 173 patients at a time other than DSA. Eight (72.7%) of the 11 patients experienced rebleeding during three-dimensional rotational angiography (3DRA). The incidence of rebleeding during DSA was 0.6% in patients with ruptured intracranial aneurysms. Multivariate logistic regression analysis showed that aneurysm location in anterior circulation [odds ratio=14.286; 95% confidence interval (CI), 1.877 to 250.0; p=0.048] and higher aspect ratio (odds ratio=3.040; 95% CI, 1.896 to 10.309; p=0.041) remained independent risk factors for rebleeding during DSA.

Conclusion: Ruptured aneurysms located in anterior circulation with a high aspect ratio might have the risk of rebleeding during DSA, especially during 3DRA.

Keywords: Cerebral angiography; intracranial aneurysm; rebleeding; subarachnoid hemorrhage.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured
  • Angiography, Digital Subtraction / methods*
  • Cerebral Angiography / methods*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Incidence
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / epidemiology
  • Intracranial Aneurysm / therapy
  • Intracranial Hemorrhages / epidemiology*
  • Male
  • Middle Aged
  • Recurrence
  • Risk Factors
  • Tomography, X-Ray Computed