METHODS: MEDLINE/PubMed, EMBASE, and Cochrane Library were queried from inception until December 2023. The primary outcome of this study was CCAA-related mortality. The secondary outcomes of this study were aneurysm growth, intracranial ischemic and hemorrhagic events, improved non-cerebrovascular symptoms, and new or worsened non-cerebrovascular symptoms during follow-up.
RESULTS: Ten studies met our inclusion criteria, involving 835 patients and 975 CCAAs. CCAA-related mortality had an incidence rate of 0.28 (95% CI 0.12-0.64) per 100 person-years (PYs) of follow-up. The incidence rate of CCAA growth was 2.91 (1.05-8.07) per 100 PYs of follow-up. The incidence rate of CCAA-related intracranial ischemic events was 0.4 (0.16-1.01) per 100 PYs of follow-up. The incidence rate of CCAA-related intracranial hemorrhagic events was 0.54 (0.33-0.87) per 100 PYs of follow-up. The incidence rate of improved non-cerebrovascular symptoms was 2.51 (1.18-5.33) per 100 PYs of follow-up. The incidence rate of new or worsened non-cerebrovascular symptoms was 3.41 (2.03-5.73) per 100 PYs of follow-up.
CONCLUSIONS: CCAAs are typically benign lesions with a low risk of rupture and life-threatening complications. CCAAs tend to follow an indolent course regarding non-cerebrovascular outcomes, and new or worsening symptoms are infrequent during the clinical course. However, spontaneous resolution of non-cerebrovascular symptoms and cranial nerve deficits at presentation is uncommon.
方法:MEDLINE/PubMed,EMBASE,和Cochrane图书馆从成立到2023年12月都被查询。这项研究的主要结果是CCAA相关的死亡率。这项研究的次要结果是动脉瘤生长,颅内缺血和出血事件,改善非脑血管症状,随访期间出现新的或恶化的非脑血管症状。
结果:10项研究符合我们的纳入标准,涉及835名患者和975名CCAA。CCAA相关死亡率的发生率为每100人年随访0.28(95%置信区间0.12-0.64)。每100个PYs随访,CCAA生长的发生率为2.91(1.05-8.07)。每100个PYs随访,CCAA相关颅内缺血事件的发生率为0.4(0.16-1.01)。CCAA相关颅内出血事件的发生率为0.54(0.33-0.87)/100个随访期。改善的非脑血管症状的发生率为每100个PYs的2.51(1.18-5.33)。新的或恶化的非脑血管症状的发生率为每100个PYs的随访3.41(2.03-5.73)。
结论:CCAAs是典型的良性病变,破裂和危及生命的并发症风险低。CCAAs倾向于遵循关于非脑血管结果的惰性过程,在临床过程中很少出现新的或恶化的症状。然而,出现时非脑血管症状和颅神经缺陷的自发消退并不常见。