Abstract 758: Concurrent Intracranial Aneurysms in Patients with Thoracic Aortic Aneurysms
Background: Patients can have aneurysms in multiple vascular trees, but the prevalence of intracranial aneurysms (ICA) in patients with thoracic aortic aneurysms (TAA) is not known. This investigation is directed at this question: Should patients with thoracic aortic aneurysms have concurrent intracranial imaging?
Methods: Records of 153 patients with thoracic aortic aneurysms and concurrent brain images (CTA or MRA scans) were analyzed. A bivariate statistical analysis was used to compare subgroups.
Results: We found that patients with thoracic aneurysms have a 10% incidence of ICA (15 of 153 patients), a tenfold increase from general population. The location of thoracic aneurysm also influences the prevalence of ICA: the probability of intracranial aneurysm in patients with descending TAA is significantly higher, 30% (6 of 20 patients), compared to 6.8% with ascending TAA (9 of 133 patients, p = 0.006). Other risk factors that increase the rate of ICA in TAA patients include hypertension 13% (14 of 107 patients) versus 2.2% of normotensive patients (1 of 46 patients, p = 0.04) and smoking 15% (10 of 65 patients) versus 4.8% of nonsmokers (4 of 84 patients, p = 0.04). Race, age and gender did not have significant impact on prevalence of concurrent intracranial aneurysms.
Conclusion: There is a definite cross-over between thoracic and intracranial aneurysm disease. We suggest that patients with thoracic aortic aneurysms be screened for intracranial aneurysm. This is important not only for long-term protection of the patient from cerebral consequences, but also for peri-operative awareness at the time of thoracic aneurysm resection.