Morbidity was defined as development of a new neurological deficit with either a modified Rankin scale >= 3 or a Mini-Mental Status Examination < 24.
Risk factors for post-procedural morbidity in multivariate analysis:
(1) diameter of the aneurysm >= 13 mm
(2) location in the posterior distribution
|
Risk Factor
|
Odds Ratio
|
95% CI
|
p value
|
|
< 13 mm vs >= 13 mm
|
0.29
|
0.09 – 0.96
|
0.041
|
|
anterior vs posterior distribution
|
0.24
|
0.06 – 0.95
|
0.042
|
where 1/0.29 = 3.45 and 1/0.24 = 4.17
|
Finding
|
Percent with Early Morbidity
|
Percent with Late Morbidity
|
|
diameter < 13 mm
|
10.6%
|
4.9%
|
|
diameter >= 13
|
27.3%
|
13.6%
|
|
anterior circulation
|
11.5%
|
4.4%
|
|
posterior circulation
|
33.3%
|
25%
|
from Table 2
Factors not found statistically significant for poor outcome but which may affect the decision to treat include:
(1) advanced age (age by itself would not preclude a procedure in a healthy elder with an accessible aneurysm)
(2) presence of severe comorbid conditions
Additional features of the aneurysm that may make a procedure more difficult:
(1) broad neck (> 4 mm)
(2) calcified neck
The presence of multiple incidental aneurysms may be associated with a high morbidity but was not found statistically significant (p = 0.30) in the current study (Table 2).
