Difference in rupture risk between familial and sporadic intracranial aneurysms: an individual patient data meta-analysis

Objective: We combined individual patient data (IPD) from prospective cohorts of patients with unruptured intracranial aneurysms (UIA) to assess to what extent patients with familial UIA have a higher rupture risk than those with sporadic UIA. Methods: For this IPD meta-analysis we performed an Embase and Pubmed search for studies published up to December 1, 2020. We included studies that 1) had a prospective study design; 2) included 50 or more patients with UIA; 3) studied the natural course of UIA and risk factors for aneurysm rupture including family history for aneurysmal subarachnoid haemorrhage and UIA; and 4) had aneurysm rupture as an outcome. Cohorts with available IPD were included. All studies included patients with newly diagnosed UIA visiting one of the study centers. The primary outcome was aneurysmal rupture. Patients with polycystic kidney disease and moyamoya disease were excluded. We compared rupture rates of familial versus sporadic UIA using a Cox proportional h...研究目标：本研究合并未破裂颅内动脉瘤（Unruptured Intracranial Aneurysms, UIA）患者前瞻性队列的个体患者数据（Individual Patient Data, IPD），以评估家族性UIA患者的破裂风险相较于散发性UIA患者高出的程度。 研究方法：针对此项个体患者数据荟萃分析，我们检索了Embase及PubMed数据库中截至2020年12月1日发表的相关研究。纳入标准如下：1）采用前瞻性研究设计；2）纳入至少50例UIA患者；3）针对UIA的自然病程及动脉瘤破裂危险因素（包括动脉瘤性蛛网膜下腔出血及UIA的家族史）开展研究；4）以动脉瘤破裂作为结局指标。本研究纳入可获取个体患者数据的队列。所有纳入研究的受试者均为就诊于各研究中心的新诊断UIA患者。本研究的主要结局指标为动脉瘤破裂。合并多囊肾及烟雾病的患者被排除出本研究。我们采用Cox比例风险（Cox proportional hazards）模型比较家族性与散发性UIA的破裂率……