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Intracranial aneurysm rupture score may correlate to the risk of rebleeding before treatment of ruptured intracranial aneurysms

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Abstract

Background and objective

Aneurysm rebleeding after rupture can result in a catastrophic outcome with high mortality and morbidity. In this study, we evaluated the correlation of IARS (intracranial aneurysm rupture score) and aneurysm rebleeding. The aim of this study was to explore the clinical utility of IARS for better clinical decision-making.

Method

The patients with ruptured intracranial aneurysms between January 2017 and September 2018 were reviewed. Propensity scoring match was performed to construct a cohort. The morphological and hemodynamic parameters were obtained. The difference between stable aneurysms and rebleeding aneurysms was compared. Subsequently, the correlation of IARS and aneurysm rebleeding was studied.

Results

The matching process constructed a cohort, including 5 rebleeding aneurysms and 15 stable aneurysms. By comparing the difference between stable aneurysms and rebleeding aneurysms, the statistical significance was found in diameter of neck (p = 0.036), aspect ratio (p = 0.004) and size ratio (p = 0.029), normalized wall shear stress average (p = 0.026), low shear area ratio (p = 0.028), oscillatory shear index (OSI) (p = 0.031), and deviated angle (p = 0.025). The IARS here had a strong correlation with the aneurysm rebleeding, and the interval from the first bleeding to the rebleeding tended to shorten with the increase of IARS (R = 0.715, p = 0.027). IARS had a good predicting value for the aneurysm rebleeding (area under the curve = 0.756, p < 0.001).

Conclusion

Based on this preliminary study, intracranial aneurysm rupture score may correlate to the rebleeding in ruptured aneurysms. For ruptured aneurysms with high IARS scores, surgery should be given priority, and medical treatment is not recommended.

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Funding

This study was supported by the National Natural Foundation of China (Grant No. 81471210 and 81671129, Recipient: Shuo Wang) and Major special projects in the 13th five-year plan (Grant No.2016YFC1301800, Recipient: Shuo Wang).

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, People’s Republic of China

    Qingyuan Liu, Pengjun Jiang, Jun Wu, Maogui Li, Yong Cao & Shuo Wang

  2. China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China

    Qingyuan Liu, Pengjun Jiang, Jun Wu, Maogui Li, Yong Cao & Shuo Wang

  3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China

    Qingyuan Liu, Pengjun Jiang, Jun Wu, Maogui Li, Yong Cao & Shuo Wang

  4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People’s Republic of China

    Qingyuan Liu & Pengjun Jiang

  5. School of Life Science and BioEngineering, Beijing University of Technology, Beijing, 100124, People’s Republic of China

    Bin Gao

  6. Department of Blood Transfusion, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, People’s Republic of China

    Yanan Zhang

  7. Department of Neurosurgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, 510220, Guangdong, People’s Republic of China

    Bo Ning

Authors
  1. Qingyuan Liu
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  2. Pengjun Jiang
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  8. Yong Cao
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  9. Shuo Wang
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Contributions

Author contributions to the study and manuscript preparation include the following. Conception and design: all authors. Acquisition of data: Q.L. Analysis and interpretation of data: Q.L, P.J. Drafting the article: Q.L. Critically revising the article: all authors. Reviewing submitted version of manuscript: all authors. Approving the final version of the manuscript on behalf of all authors: S.W. Administrative/technical/material support: S.W and B.G. Study supervision: S.W and J.W.

Corresponding author

Correspondence to Shuo Wang.

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Liu, Q., Jiang, P., Wu, J. et al. Intracranial aneurysm rupture score may correlate to the risk of rebleeding before treatment of ruptured intracranial aneurysms. Neurol Sci 40, 1683–1693 (2019). https://doi.org/10.1007/s10072-019-03916-1

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