Abstract：Objective: To investigate the potential clinical and imaging risk factors for the rupture of multiple intracranial aneurysms.Methods: A retrospective analysis of the clinical and imaging data of patients with multiple intracranial aneurysms treated in our hospital from April 2013 to December 2021 was conducted. Patients were divided into rupture and non-rupture groups based on whether their aneurysms had ruptured. Univariate analysis was performed on the clinical and imaging parameters of both groups to identify statistically significant risk factors, which were then used as independent variables for further multivariate Logistic regression analysis to explore the risk factors influencing the rupture of multiple intracranial aneurysms.Results: Univariate regression analysis indicated significant differences between the rupture group (n=52) and the non-rupture group (n=85) in terms of age, gender, hypertension, hyperlipidemia, atherosclerotic diseases, maximum aneurysm diameter, width, aspect ratio, and aneurysm location (all P<0.05). Younger age was associated with a higher likelihood of rupture (P<0.05). The rupture group had significantly greater maximum diameter, width, and aspect ratio than the non-rupture group (P<0.05). Aneurysms located in the anterior communicating artery, posterior communicating artery, middle cerebral artery, and basilar artery had higher rupture rates compared to aneurysms in other locations (P<0.05). Multivariate Logistic regression analysis identified gender (OR=3.664, 95%CI): 1.577~8.515, P=0.003), maximum aneurysm diameter (OR=1.405, 95% CI: 1.130~1.747, P=0.002), and aneurysm location as independent risk factors for the rupture of multiple intracranial aneurysms. Specifically, aneurysms in the anterior communicating artery (OR=26.747, 95% CI: 5.384~132.883, P<0.001) and posterior communicating artery (OR=15.288, 95% CI: 3.659~63.885, P<0.001) had the highest risk of rupture. Hyperlipidemia was identified as an independent protective factor against the rupture of multiple intracranial aneurysms (OR=0.103, 95% CI: 0.026~0.405, P=0.001). Conclusion: Gender, maximum aneurysm diameter, and aneurysm location are independent risk factors for the rupture of multiple intracranial aneurysms, while hyperlipidemia is an independent protective factor. These findings provide crucial evidence for the development of personalized preventive strategies for unruptured aneurysms in patients with multiple intracranial aneurysms.
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2024, Vol. 30 
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