Abstract
Background: We sought to evaluate the clinical outcomes and association of therapeutic intervention with activities of daily living (ADL) in patients with unruptured intracranial aneurysms (UIAs) during follow-up.
Methods: Study cohort comprised 346 patients (mean age: 65.9 years, median follow-up length: 63.5 months) with UIA ≥ 2 mm, and was retrospectively analyzed. ADL decline was defined as deterioration of the modified Rankin Scale.
Results: ADL decline occurred in 46 patients (13.3%, annual incidence rate [AI]: 2.5%, excluding deaths: 22 patients, 6.4%). Twenty-four deaths (6.9%, annual mortality rate: 1.3%) and eight UIA ruptures (2.3%, AI: 0.43%) were observed. The propensity score-matched cohort analysis revealed that intervention corresponded to a lower hazard ratio (HR) for ADL decline in patients with UIA ≥ 5 mm (HR, 0.24; P = 0.028) and eliminated the risk of aneurysm rupture (P < 0.0001). A significantly higher HR (HR, 4.73; P = 0.005) for ADL decline in patients aged ≥ 70 years was also demonstrated.
Conclusions: Therapeutic intervention could prevent UIA rupture and might not contribute to reducing ADL in patients with UIA ≥ 5 mm. In elderly patients, ADL declined; however, therapeutic intervention might not be a major cause.
