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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuroepidemiology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1566246
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Background: The natural course of unruptured intracranial aneurysms (UIAs) has been well described in developed countries, but there is a lack of large studies on UIAs in China. This article aims to fill this gap by detailing the current status and natural course of UIAs in China and identifying the major risk factors for their rupture, providing a basis for clinical decision-making.Method: We included all patients with UIAs consecutively admitted to 12 tertiary care centers in 4 provinces in northern China between January 2017 and December 2020. The mean follow-up was 3.1 years (range 0-7.3 years). The current status of UIA patients in China was described in detail. Risk ratios for rupture were analyzed using the Cox proportional hazards model, and Kaplan-Meier curves were analyzed for long-term rupture rates. Results: In this study, among the 1,475 patients, 33.4% declined surgical treatment. Of the 1,189 patients who completed follow-up, 10.3% initially received conservative treatment but later underwent surgery. A total of 1,337 patients with UIAs who met the criteria were included in the statistical analysis. The annual rupture rate was 1.75%. Cox proportional hazards model identified the following risk factors for rupture: age over 70 years (HR 2.136, 95% CI 1.302–3.504, p=0.003), aneurysm size of 10–20 mm (HR 3.543, 95% CI 1.501–8.363, p=0.004) and ≥20 mm (HR 4.455, 95% CI 1.034–19.187, p=0.045). ICA (HR 0.427, 95% CI 0.203–0.897, p=0.025) was a protective factor.Conclusion: In China, treatment options for UIA patients are unique, with a low willingness to undergo surgery leading to a higher rupture rate. A significant percentage of Chinese patients refuse treatment, and those who initially choose conservative management are unlikely to opt for surgical intervention later. Advanced age, specific locations, and size are associated with UIA rupture. This study has important implications for clinical decision-making, public awareness of UIAs, and the development of health policies.
Keywords: Intracranial Aneurysm, Natural course, current status, Risk factors, Rupture rate
Received: 24 Jan 2025; Accepted: 27 Mar 2025.
Copyright: © 2025 An, Huan, Liu, Zhao, Zhang, Li, Lin, Wang, Jiheng, Yang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Bangyue Wang, Tianjin Medical University General Hospital, Tianjin, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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