Original ArticleIntracranial Aneurysms in Patients With Coarctation of the Aorta: A Prospective Magnetic Resonance Angiographic Study of 100 Patients
Section snippets
PATIENTS AND METHODS
After approval from the Mayo Foundation Institutional Review Board, patients with a history of CoA evaluated at the Mayo Clinic in Rochester, Minn, from January 1, 1980, to September 30, 2002, were identified. A letter containing detailed information about the potential association of IA and CoA as well as possible indications for a noninvasive presymptomatic MRA evaluation was sent to the patients. Those interested in participating in the study contacted the investigators. All study
RESULTS
We contacted 277 patients with the diagnosis of CoA who had been evaluated at Mayo Clinic since 1980; 100 patients (70 men and 30 women) volunteered to be in the study (Table 1). The mean ± SD age at the time of MRA was 41.6±16.5 years. Eighty-six patients who had previous surgical repair for CoA underwent cranial MRA to determine the presence or absence of IA (Table 1). Coarctation of the aorta is more common among men than women, and our population reflects this bias. The initial diagnosis of
DISCUSSION
Intracranial aneurysms were detected with MRA in 10 (10%) of 100 patients with CoA. Because of referral and selection biases, as well as nonresponse bias, this frequency should be considered an approximation.
CONCLUSIONS
There is approximately a 5-fold increase in the frequency of IAs in patients with CoA compared with that of the general population. No risk factors for aneurysm were identified. In approximately 10% of patients with CoA, MRA screening detects an IA. Although most IAs detected were small and are being monitored, treatment was necessary in one patient. These data suggest that cerebral MRA or computed tomographic angiography screening should be considered for adults with CoA.
We thank A. Gabriela
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