Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-22T23:10:05.620Z Has data issue: false hasContentIssue false
  • English
  • Français

Intracranial aneurysm and coarctation of the aorta: prevalence in the current era

Published online by Cambridge University Press:  06 November 2020

Lauren Andrade Open the ORCID record for Lauren Andrade [Opens in a new window] ,
Arvind Hoskoppal ,
Mary Hunt Martin Open the ORCID record for Mary Hunt Martin [Opens in a new window] ,
Kevin Whitehead ,
Zhining Ou ,
Jinqiu Kuang  and
Daniel Cox
Lauren Andrade*
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, University of Pennsylvania Health, Philadelphia, PA, USA Department of Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Arvind Hoskoppal
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA Department of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Mary Hunt Martin
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA
Kevin Whitehead
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA
Zhining Ou
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA
Jinqiu Kuang
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA
Daniel Cox
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA
*
Author for correspondence: L. Andrade, MD, Department of Cardiology, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA. Tel: +1 (267)-624-4445; Fax: 215-349-5927. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

A 10% prevalence of intracranial aneurysms in patients with coarctation of the aorta has been described in a few studies. Our objective is to describe the rate of intracranial aneurysm detection in patients with coarctation of the aorta in the current era. We hypothesise that, with earlier detection and coarctation of the aorta intervention, the rate of intracranial aneurysm is lower than previously reported and screening imaging may only be warranted in older patients or patients with certain risk factors.

Methods:

This is a retrospective study of 102 patients aged 13 years and older with coarctation who underwent brain computed tomography angiography, magnetic resonance imaging (MRI), or magnetic resonance angiography between January, 2000 and February, 2018.

Results:

The median age of coarctation repair was 4.4 months (2 days–47 years) and the initial repair was primarily surgical (90.2%). There were 11 former smokers, 4 current smokers, and 13 patients with ongoing hypertension. Imaging modalities included computed tomography angiography (13.7%), MRI (41.2%), and magnetic resonance angiography (46.1%), performed at a median age of 33.3 years, 22.4 years, and 25 years, respectively. There were 42 studies performed for screening, 48 studies performed for neurologic symptoms, and 12 studies performed for both screening and symptoms. There were no intracranial aneurysms detected in this study.

Conclusions:

These results suggest that the rate of intracranial aneurysms may be lower than previously reported and larger studies should explore the risk of intracranial aneurysms in coarctation of the aorta in the current era.

Keywords

Coarctation of the aortaintracranial aneurysmadult congenital heart disease
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 2 , February 2021 , pp. 229 - 232
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Reller, MD, Strickland, MJ, Riehle-Colarusso, T, Mahle, WT, Correa, A Prevalence of congenital heart defects in metropolitan Atlanta, 1998–2005. J Pediatr 2008; 153: 807–813.CrossRefGoogle Scholar
Warnes, CA, Williams, RG, Bashore, TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008; 52: e143–e263.CrossRefGoogle Scholar
Eppinger, H. Stenosis aortae eongenita seu isthmus persistans. Vjschr Parkt Heilk 1871; 112: 31–67.Google Scholar
Connolly, HM, Huston, J, Brown, RD, Warnes, CA, Ammash, NM, Tajik, AJ. Intracranial aneurysms in patients with coarctation of the aorta: a prospective magnetic resonance angiographic study of 100 patients. Mayo Clin Proc 2003; 78: 1491–1499.CrossRefGoogle ScholarPubMed
Egbe, AC, Padang, R, Brown, RD, et al. Prevalence and predictors of intracranial aneurysms in patients with bicuspid aortic valve. Heart 2017; 103: 1508–1514.CrossRefGoogle ScholarPubMed
Curtis, SL, Bradley, M, Wilde, P, et al. Results of screening for intracranial aneurysms in patients with coarctation of the aorta. AJNR Am J Neuroradiol 2012; 33: 1182–1186.CrossRefGoogle ScholarPubMed
Cook, SC, Hickey, J, Maul, TM, et al. Assessment of the cerebral circulation in adults with coarctation of the aorta. Congenit Heart Dis 2013; 8: 289–295.10.1111/chd.12024CrossRefGoogle ScholarPubMed
Pickard, SS, Gauvreau, K, Gurvitz, M, et al. Stroke in adults with coarctation of the aorta: a national population-based study. J Am Heart Assoc 2018; 7: e009072.10.1161/JAHA.118.009072CrossRefGoogle ScholarPubMed
Vlak, MH, Algra, A, Brandenburg, R, Rinkel, GJ. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol 2011; 10: 626–636.10.1016/S1474-4422(11)70109-0CrossRefGoogle ScholarPubMed
Wardlaw, JM, White, PM. The detection and management of unruptured intracranial aneurysms. Brain 2000; 123 (Pt 2): 205–221.CrossRefGoogle ScholarPubMed
Singh, PK, Marzo, A, Staicu, C, et al. The effects of aortic coarctation on cerebral hemodynamics and its importance in the etiopathogenesis of intracranial aneurysms. J Vasc Interv Neurol 2010; 3: 17–30.Google ScholarPubMed
Thompson, BG, Brown, RD, Amin-Hanjani, S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015; 46: 2368–2400.CrossRefGoogle ScholarPubMed
Stout, KK, Daniels, CJ, Aboulhosn, JA, et al. 2018. AHA/ACC guideline for the management of adults with congenital heart disease. Circulation 2018. doi: 10.1161/CIR.0000000000000603.Google ScholarPubMed
Donti, A, Spinardi, L, Brighenti, M, et al. Frequency of intracranial aneurysms determined by magnetic resonance angiography in children (mean age 16) having operative or endovascular treatment of coarctation of the aorta (mean age 3). Am J Cardiol 2015; 116: 630–633.10.1016/j.amjcard.2015.05.030CrossRefGoogle Scholar
Vlak, MH, Rinkel, GJ, Greebe, P, Algra, A. Risk of rupture of an intracranial aneurysm based on patient characteristics: a case-control study. Stroke 2013; 44: 1256–1259.10.1161/STROKEAHA.111.000679CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention Smoking and Tobacco Use: Data and Statistics. 2019. https://www.cdc.gov/tobacco/data_statistics/index.htm.Google Scholar
Caliskan, E, Pekcevik, Y, Kaya, A. Can we evaluate cranial aneurysms on conventional brain magnetic resonance imaging? J Neurosci Rural Pract 2016; 7: 83–86.Google ScholarPubMed
Villablanca, JP, Duckwiler, GR, Jahan, R, et al. Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors. Radiology 2013; 269: 258–265.10.1148/radiol.13121188CrossRefGoogle ScholarPubMed