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The Prevalence of Incidental Unruptured Intracranial Aneurysms in Male Smokers: A Nested Case Control Study

Friday, May 3, 2024

    Presenting Author(s)

  • Thomas B. Fodor, BSc

    Research Trainee
    Beth Israel Deaconess Medical Center

    • Co-Author(s)

  • Bernard R. Bendok, MD, MSCI

    Chair of Mayo Clinic Arizona Department of Neurological Surgery
    Mayo Clinic Arizona Department of Neurological Surgery, Precision Neuro-Therapeutics Innovation Laboratory, Neurosurgery Simulation and Innovation Laboratory
    Phoenix, Arizona, United States

  • Jean Filo, n/a

    Medical Student
    Harvard Medical School, United States

  • SG

    Santiago Gomez-Paz, MD

    Pre-Residency Neurosurgery Fellow
    Mount Sinai Hospital, New York City, United States

  • TL

    Tzak Lau, n/a

    Research Trainee
    Beth Israel Deaconess Medical Center, United States

  • Christopher S. Ogilvy, MD

    Endovascular and Operative Neurovascular Surgery
    BIDMC Brain Aneurysm Institute, Neurosurgical Division, Beth Israel Deaconess Medical Center. Harvard Medical School. Boston, MA, United States.
    Boston, Massachusetts, United States

  • SP

    Samuel Pettersson, n/a

    Research Fellow
    Neurosurgical Division, Beth Israel Deaconess Medical Center. Harvard Medical School. Boston, MA, United States., United States

  • Mira Salih, M.D.

    Clinical Research Fellow
    Beth Israel Deaconess Medical Center - Harvard Medical School
    Boston, Massachusetts, United States

  • PT

    Philipp Taussky, MD

    Endovascular and Operative Neurovascular Surgery
    Neurosurgical Division, Beth Israel Deaconess Medical Center. Harvard Medical School. Boston, MA, United States., United States

  • ET

    Evelyn Turcotte, BS

    Medical Student
    Mayo Clinic Alix School of Medicine - Arizona Campus, Neurosurgery Simulation and Innovation Laboratory, Precision Neuro-Therapeutics Innovation Laboratory, United States

  • Michael Young, D.O.

    Cerebrovascular Fellow, Neurosurgical Division
    Beth Israel Deaconess Medical Center. Harvard Medical School. Boston, MA, United States.
    Boston, Massachusetts, United States

Introduction: The prevalence of unruptured intracranial aneurysms(UIA) in female cigarette smokers has been explored in recent studies, however that of male smokers has not been the subject of a unique investigation.
This study aims to investigate the prevalence of incidental unruptured intracranial aneurysms(UIAs) among male smokers, and the association with risk factors such as hypertension and other comorbidities.

Methods: We conducted a dual center nested case control study from a cohort of male patients aged 20-80 with a brain magnetic resonance angiography (MRA) between 2019 and 2022. Incidental UIAs were compared to patients with normal MRA in a 1:2 ratio. The association between smoking, hypertension and other comorbidities with diagnosis of incidental UIA was evaluated with logistic regression.

Results: A total of 3149 male patients ages 20-80 with MRAs in the time period of 2019 to 2022 were included. A total of 456 patients were included in the 2:1 nested case control study. Of current and former smokers, 89 of 1116 had aneurysms (7.97%), while 63 of 2033 nonsmokers(3.10%), had aneurysms. Of 152 aneurysm patients and 304 random controls, aneurysm patients were more likely to have a positive smoking history compared with healthy controls (58.55 % vs 34.27 % p= < 0.01). And multivariate regression analysis demonstrated a significant association between current smoking and incidental UIA (OR: 2.7, 95% CI: 1.94 - 3.77).

Conclusion : Males smoking or with a history of smoking cigarettes have a higher prevalence of UIAs than the general population. Smoking confers a higher risk for having a silent UIA. This population may pose a target for screening.