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J Clin Neurosci. 2019 Nov;69:220-223. doi: 10.1016/j.jocn.2019.07.048. Epub 2019 Jul 29.

Aneurysm morphology in patients with autosomal dominant polycystic kidney disease: A case-control study.

Author information

1
School of Medicine, University of Minnesota, Minneapolis, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
2
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
3
Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
4
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA. Electronic address: lanzino.giuseppe@mayo.edu.

Abstract

PURPOSE:

Approximately 8% of patients with autosomal dominant polycystic kidney disease (ADPKD) develop intracranial aneurysms. The reason for development of intracranial aneurysms in ADPKD patients might be related to interactions between the presence of hypertension and the basic mechanism underlying the disease, which leads to weakness of the connective tissue. In this study, we aimed to identify differences in aneurysm morphology between ADPKD patients and a location-matched set of controls.

METHODS:

A total of 42 ADPKD patients and 49 control patients with 122 aneurysms were included. Aneurysm size, location, and morphology were evaluated by two neuroradiologists. Aneurysm morphology was classified into one of three groups: regular saccular, irregular saccular, and fusiform. Continuous variables were compared with chi-squared tests and categorical variables were compared with student's t-test.

RESULTS:

When considering all patients, there was no significant difference in aneurysm morphology or size (4.5 ± 2.6 mm vs 5.4 ± 2.9 mm; p = 0.09) between the ADPKD and control group. In a subgroup analysis of medium and large aneurysms (n = 61), there was a significantly lower incidence of regular saccular aneurysms (28% vs. 56%; p = 0.03) and higher incidence of fusiform aneurysms (12% vs 0%; p = 0.03) in the ADPKD group compared to a control group.

CONCLUSION:

When excluding categorically "small" aneurysms, there is a reduced incidence of regular saccular aneurysms and increased incidence of fusiform aneurysms in ADPKD patients compared to a control group. Further study of this population of patients is warranted to better understand their risks of aneurysm rupture and indications for treatment.

KEYWORDS:

Autosomal dominant polycystic kidney disease; Intracranial aneurysm; Morphology; Rupture

PMID:
31371190
DOI:
10.1016/j.jocn.2019.07.048
[Indexed for MEDLINE]

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