Introduction: Intracranial (IA) and aortic aneurysms (AA) share genetic and environmental risks. In a retrospective review of clinical data, we identified those presenting with IA (+/- subarachnoid hemorrhage), who also had abdominal or thoracic imaging.
Method: In the University of Virginia (UVA) Clinical Data Repository we searched for patients with IA by ICD-9 diagnosis codes and CPT treatment codes. We used three strategies to identify those with aortic imaging: 1) ICD-9 diagnosis codes for AA, 2) CPT and billing codes for abdominal or thoracic imaging (aortogram, ultrasound, angiography, magnetic resonance, and computerized tomography), and 3) CPT and billing codes for AA treatment (endovascular, stent, graft, wrap, or screening). We reviewed all charts to identify those with confirmed IA and imaging. We performed a multivariable logistic regression analysis accounting for sex, age, hypertension, diabetes mellitus, smoking status, and IA size, multiplicity, and location to look for associations with AA.
Results: Among individuals seen at UVA hospital from 2004 to 2015, we identified 13245 cases with a possible IA, of whom 1017 potential aortic imaging. Our review of charts revealed that 720 did not having an IA. Of the remaining 287 cases, 51 lacked appropriate aortic imaging. We recorded information from the remaining 236 cases - 94/236 (39.8%) had an AA identified. In our multivariable analysis, only female sex was significantly associated with a co-prevalent AA (Odds Ratio: 0.20, 95% confidence interval 0.09 - 0.45). In the table, we provide descriptive statistics for those with and without AA as well as the subsets with thoracic aortic aneurysms (TAA) and abdominal aortic aneurysms (AAA).
Conclusion: The co-prevalence of AA in a clinical population known to have IA and with aortic imaging was 39.8%. Men had higher risk for AA. This indicates a shared risk for aneurismal disease in the aorta and brain warranting prospective investigation on the mechanisms of risk.