Impact of Menopausal age on Size of Unruptured Intracranial Aneurysms and Their Outcomes With Endovascular Therapy (I2-4B)

OBJECTIVE: The present study aims to determine unruptured intracranial aneurysm (UIA) size, treatment complications and outcomes with endovascular therapy (ET) among pre-menopausal (PRM) and post-menopausal (POM) women. BACKGROUND: UIAs occur about twice more commonly in women compared to men. Prevalence increases more rapidly in women with age: 2.7[percnt] below 40 years, increases to 5.4[percnt] above age 50. The impact of menopausal age, if any, on UIAs and treatment outcomes with ET has not been well studied. We hypothesized that higher estrogen in pre-menopausal women may have a protective effect on presentation size and treatment outcomes. DESIGN/METHODS: We performed a retrospective analysis of consecutive female patients with UIAs treated with ET at our academic tertiary care center from 2008 through 2013. We recorded UIA characteristics, complications and outcomes and compared them among the group below the mean menopausal age of 51 years (in USA) and those at or above this age. RESULTS: A total of 145 patients were included. 30 patients were in the PRM group and 115 in the POM group. Mean age was 43 and 65 years in the PRM and POM groups. There was no difference in the prevalence of hypertension, smoking and alcohol consumption between the two groups. Mean size of aneurysms in the PRM group was 10.2mm whereas that in the POM group was 8.8mm. There were fewer complications in the PRM group than in the POM group (1.5[percnt] and 4.0[percnt] respectively). At follow-up, recanalization was observed in 3/30 (10[percnt]) patients in the PRM group and 10/115(8.6[percnt]) patients in the POM group. 1 patient in the PRM group and 2 in the POM group required re-treatment. CONCLUSIONS: Women under the mean menopausal age of 51 years with UIAs present with larger aneurysms but have fewer treatment complications and lesser recanalization with ET. Study Supported by: None Disclosure: Dr. Dharmadhikari has nothing to disclose. Dr. Atchaneeyasakul has nothing to disclose. Dr. Ajiboye has nothing to disclose. Dr. Ambekar has nothing to disclose. Dr. Yavagal has received personal compensation for activities with Stryker, Covidien/evV3, and Aldagen/Cytomedix.