Abstract：
BACKGROUND: Cavernous carotid artery aneurysms (CCAAs) represent a common condition seen in clinical practice with significant practice variability. The aim of this systematic review and meta-analysis was to aggregate current evidence on the natural history of CCAAs.
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.
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.
摘要：
背景：海绵状颈动脉动脉瘤（CCAAs）是临床实践中常见的疾病，具有明显的实践变异性。本系统综述和荟萃分析的目的是汇总当前有关CCAAs自然史的证据。
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。
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。
