A Analysis Of The Risk Factor Of The Rupture Of Middle Cerebral Artery Aneurysm

Objective:Middle cerebral artery aneurysm(MCAA)is one of the most common intracranial aneurysms and it is easier to rupture than other intracranial aneurysms.Most previous studies have covered most intracranial aneurysms,which are inevitably interfered by many confounding factors.This study aimed to collect the clinical and imaging data of patients with ruptured or unruptured MCAA and investigate the relation between these factors and aneurysm rupture,so as to provide reference for the clinical diagnosis and treatment of middle cerebral artery aneurysm.Methods:This study collected 102 patients with unruptured single middle cerebral artery aneurysm and 99 patients with ruptured single middle cerebral artery aneurysm.All patients received treatment in Cangzhou Central Hospital from January 2015 to June 2020.The data,including the patient’s gender,age,history of hypertension,diabetes history,long-term smoking history,abnormal coagulation function,and abnormal number of platelets,the side of the aneurysm,aneurysm sac,bifurcation,aneurysm height(H),aneurysm width(W),aneurysm neck width(Wneck),aneurysm height to neck ratio(AR ratio).Univariate and multivariate analysis were applied to investigate the relation between abovementioned factors and aneurysm rupture to provide reference for the clinical diagnosis and treatment of MCAA.Results:A total of 201 cases were included in this study,of which 99were ruptured and bleeding,and 102 were unruptured.The results of univariate analysis showed that the patient’s age(χ~2=11.055,P=0.001),history of hypertension(χ~2=13.572,P=0.014),history of diabetes(χ~2=13.109,P=0.000),and smoking history(χ~2=36.935,P=0.000),abnormal coagulation function(χ~2=13.572,P=0.000),and the presence of daughter sacs(χ~2=8.600,P=0.004)were statistically significant.Gender(χ~2=2.58,P=0.119),history of hypertension(χ~2=3.615,P>0.05),abnormal platelet count(χ~2=4.503,P=0.065),bifurcation(χ~2=0.037,P=0.883),aneurysm height(χ~2=4.587,P=0.106),aneurysm width(χ~2=2.957,P=0.110),and the ratio of aneurysm height to neck width(χ~2=0.082,P=0.873)were not statistically significant.Multivariate logistic analysis suggested that history of diabetes(OR=2.653,P=0.004),history of long-term smoking(OR=3.369,P=0.001),abnormal blood coagulation(OR=4.593,P=0.003),the presence of daughter sacs(OR=4.141,P=0.019)and AR ratio>1.6(OR=0.488,P<0.001)are statistically significant.Conclusions:Diabetes history,long-term smoking history,abnormal blood coagulation function,the presence of daughter sacs,and AR ratio>1.6are risk factors for MCAA rupture.