• Ville Rantasalo, Jarmo Gunn, Emily Pan, Tuomas Kiviniemi, Jussi Hirvonen, Melissa Rahi, Terhi Fordell, Jaakko K Rinne, and Dan Laukka.
• Department of Surgery, University of Turku, Turku, Finland; Heart Center, Turku University Hospital, University of Turku, Turku, Finland; Department of Surgery, Mikkeli Central Hospital, Mikkeli, Finland. Electronic address: vheran@utu.fi.
• World Neurosurg. 2024 Apr 1; 184: e633e646e633-e646.

ObjectiveTo investigate the association between intracranial aneurysms (IAs) and thoracic aortic diameter.MethodsThis observational cohort study examined thoracic aortic diameters in patients with IA. Patients were categorized by IA size (<7 mm and ≥7 mm) and IA status (ruptured/unruptured) based on radiologic findings. We investigated the association between thoracic aortic diameter and IA size and status using binary and linear regression as univariate and multivariable analyses.ResultsA total of 409 patients were included. Mean age was 60 (±11.7) years and 63% were women. Thoracic aortic diameters were greater among patients who had an IA ≥7 mm versus IA <7 mm (P < 0.05). In the univariate analysis, the diameter of the ascending aorta (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.129 per 1 mm; P = 0.002), aortic arch (OR, 1.10; 95% CI, 1.04-1.15 per 1 mm; P < 0.001), and descending aorta (OR, 1.10; 95% CI, 1.03-1.16 per 1 mm; P = 0.003) were associated with IAs ≥7 mm. In the multivariable regression model, larger ascending aorta (OR, 1.09; 95% CI, 1.01-1.17 per 1 mm; P = 0.018), aortic arch (OR, 1.12; 95% CI, 1.02-1.22 per 1 mm; P = 0.013), and descending aorta (OR, 1.20; 95% CI, 1.08-1.33 per 1 mm; P < 0.001) were associated with ruptured IA.ConclusionsGreater thoracic aortic diameters are associated with a higher risk of IA being larger than 7 mm and IA rupture. Exploring the concomitant growth tendency in IA and thoracic aorta provides a basis for future considerations regarding screening and risk management.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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