Objective: To analyze the incidence of intracranial unruptured aneurysms in patients with internal carotid artery (ICA) stenosis (≥30%), the characteristics of aneurysms and risk factors in patients with ICA stenosis and intracranial aneurysm. Methods: Clinical data of patients receiving digital subtraction angiography (DSA) at Peking University Third Hospital between January 2012 and June 2015 were retrospectively reviewed to identify patients with ICA stenosis and unruptured intracranial aneurysm. Results: Among 247 patients with ICA stenosis, 16 patients (6.5%) with intracranial unruptured aneurysms were found including 7 females and 9 males with age from 47 to 83 years old. The severity of ICA stenosis in aneurysm group was (85.3±13.2)%, whereas it was (77.7±17.9)% in non-aneurysm group. The incidence of aneurysms in male patients with ICA stenosis was 4.5%(9/202), and 15.6%(7/45) in female patients (P<0.05). The incidence of aneurysms in patients with only in cervical segment (C1 segment) of ICA was 4.4%(10/226), whereas that of other segment was 28.6%(6/21) (P<0.05). Logistic multivariate regression analysis showed that gender and stenosis location were independent risk factors of aneurysms in patients with ICA stenosis. Conclusions: In patients with ICA stenosis, the incidence of aneurysm is much higher than that in general population. Intracranial aneurysms are more likely to occur in women and patients with ICA stenosis other than C1 segment.
目的： 分析未破裂颅内动脉瘤在颈内动脉狭窄（≥30%）患者中的发病率和临床特点，并探讨发生未破裂颅内动脉瘤的危险因素。 方法： 收集2012年1月至2015年6月在北京大学第三医院就诊的经数字减影血管造影（DSA）证实颈内动脉狭窄，并同时存在颅内未破裂动脉瘤的247例患者（男202例，女45例）的资料，对患者临床、DSA影像资料进行回顾分析。 结果： 在247例颈内动脉狭窄患者中，16例（6.5%）存在未破裂颅内动脉瘤，年龄47~83岁，其中女7例，男9例。动脉瘤组颈内动脉狭窄程度为（85.3±13.2）%，无动脉瘤组狭窄程度为（77.7±17.9）%，动脉瘤组狭窄程度较高，但差异尚无统计学意义（P=0.098）；男性颈内动脉狭窄患者动脉瘤发病率为4.5%（9/202），女性颈内动脉狭窄患者动脉瘤发病率为15.6%（7/45），差异有统计学意义（P<0.05）；颈内动脉颈段（C1段）狭窄的患者动脉瘤发病率为4.4%（10/226），存在颈内动脉其他部位狭窄的患者动脉瘤发病率为28.6%（6/21），差异有统计学意义（P<0.05）。多因素logistic二元回归分析显示，性别（女性）及狭窄部位（颈内动脉C1段以外）是颈内动脉狭窄患者发生动脉瘤的独立危险因素。 结论： 颈内动脉狭窄患者发生动脉瘤的可能性远高于普通人群，女性及颈内动脉C1段以外部位狭窄的患者更容易发生颅内动脉瘤。.
Keywords: Carotid stenosis; Risk factors; Unruptured intracranial aneurysm.