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Introduction: Previous studies have shown that unruptured intracranial aneurysm (UIA) growth and rupture are strongly associated with each other, with an increasing number of aneurysms followed clinically, especially UIA smaller than 7 mm.Hypothesis: Patient-specific and aneurysm-specific clinical and demographic features can predict growth and growth rates of UIA.Methods: We studied a cohort of 293 individuals diagnosed with a total of 409 intracranial aneurysms followed for an average of 27.4 months. Associations with aneurysm growth and growth rate were identified for both patient- and aneurysm-specific variables. Growth was defined as a size increase greater than 0.6 mm, with growth rate (mm/year) determined from the change in size of the aneurysm between the first and last measurement.Results: Mean initial size at diagnosis was significantly associated with risk of growth (OR: 1.09, 95% CI: 1.01-1.18, p=0.036), as was diagnosis of multiple aneurysms (OR: 2.01, 95% CI: 1.00-4.04, p=0.048) and having a positive family history (OR: 4.25, 95% CI: 1.18-15.3, p=0.041). Diagnosis of coronary artery disease (CAD) (p<0.001), diabetes (p=0.041), and gender (p=0.014) were significant for growth rate. Differences were observed for aneurysms located in different vessels, with an increased occurrence of growth at M-Bifurcation (p=0.015 vs. other MCA sites) and a high growth rate for those located in the BA trunk (p=0.0033 vs. other VABA sites).Conclusions: This analysis takes advantage of a large longitudinal cohort with multiple follow-up measurements to provide further insight regarding the characteristics of UIA growth behavior. While our data further confirm that aneurysm rupture and growth share a similar set of risk factors (size, multiplicity and family history), we additionally that found patients with CAD or diabetes had a higher aneurysm growth rate, and therefore might require more frequent follow up.