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Intracranial aneurysm and coarctation of the aorta: prevalence in the current era

Published online by Cambridge University Press:  06 November 2020

Lauren Andrade*
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, University of Pennsylvania Health, Philadelphia, PA, USA Department of Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Arvind Hoskoppal
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA Department of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Mary Hunt Martin
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA
Kevin Whitehead
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA
Zhining Ou
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA
Jinqiu Kuang
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA
Daniel Cox
Affiliation:
Department of Cardiology, University of Utah, Salt Lake City, UT, USA Department of Cardiology, Primary Children’s Medical Center, Salt Lake City, UT, USA Department of Cardiology, Intermountain Healthcare, Salt Lake City, UT, USA
*
Author for correspondence: L. Andrade, MD, Department of Cardiology, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA. Tel: +1 (267)-624-4445; Fax: 215-349-5927. E-mail: lauren.andrade@pennmedicine.upenn.edu

Abstract

Background:

A 10% prevalence of intracranial aneurysms in patients with coarctation of the aorta has been described in a few studies. Our objective is to describe the rate of intracranial aneurysm detection in patients with coarctation of the aorta in the current era. We hypothesise that, with earlier detection and coarctation of the aorta intervention, the rate of intracranial aneurysm is lower than previously reported and screening imaging may only be warranted in older patients or patients with certain risk factors.

Methods:

This is a retrospective study of 102 patients aged 13 years and older with coarctation who underwent brain computed tomography angiography, magnetic resonance imaging (MRI), or magnetic resonance angiography between January, 2000 and February, 2018.

Results:

The median age of coarctation repair was 4.4 months (2 days–47 years) and the initial repair was primarily surgical (90.2%). There were 11 former smokers, 4 current smokers, and 13 patients with ongoing hypertension. Imaging modalities included computed tomography angiography (13.7%), MRI (41.2%), and magnetic resonance angiography (46.1%), performed at a median age of 33.3 years, 22.4 years, and 25 years, respectively. There were 42 studies performed for screening, 48 studies performed for neurologic symptoms, and 12 studies performed for both screening and symptoms. There were no intracranial aneurysms detected in this study.

Conclusions:

These results suggest that the rate of intracranial aneurysms may be lower than previously reported and larger studies should explore the risk of intracranial aneurysms in coarctation of the aorta in the current era.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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