The prognostic effects of hemodynamic parameters on rupture of intracranial aneurysm: A systematic review and meta-analysis.

BACKGROUND: Many risk factors are associated with rupture of intracranial aneurysm. However, the prognostic effects hemodynamic factors on intracranial aneurysm rupture remains poorly understood. A meta-analysis was performed based on contemporary studies to evaluate the prognostic effect of hemodynamic parameters on rupture of intracranial aneurysm. METHODS: The Cochrane Library, PubMed, Embase, and Web of Science were searched for cohort studies that analyzed hemodynamic parameters for intracranial aneurysm rupture prior to May 1, 2020. The standardized mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI) were calculated to assess the effect of individual hemodynamic parameters on intracranial aneurysm rupture. The primary outcomes were difference in wall shear stress (WSS), oscillatory shear index (OSI) and low shear index (LSA) between ruptured and unruptured intracranial aneurysm. Two reviewers independently assessed the quality of the trials and the associated data. All statistical analyses were performed using standard statistical procedures in Review Manager 5.2. RESULTS: A total of 15 studies including 779 patients with 900 aneurysms were identified for this meta-analysis. The pooled results indicated that the average WSS, OSI and LSA% had significant associations with rupture of intracranial aneurysm, with pooled SMDs of -0.36 (95% CI -0.57 to -0.15; P = 0.001), 0.37 (95% CI 0.19 to 0.55; P < 0.0001) and 0.57% (95% CI 0.18 to 0.95; P = 0.004), respectively. In addition, other hemodynamic parameters, including aneurysm size, aspect ratio, mean volume, undulation index, ellipticity index, nonsphericity index, number of vorticies, and relative residence time significant associations with intracranial aneurysm rupture. Multivariate analysis indicated that circumferential wall tension, angle btwn, irregular shape and size of aneurysms were independent risk factors of intracranial aneurysm rupture. CONCLUSIONS: This meta-analysis identified WSS, OSI and LSA% as influential hemodynamic parameters on rupture of intracranial aneurysm. The roles of other hemodynamic parameters and risk factors for intracranial aneurysm rupture need further assessments in future.

RETRACTED: Knockdown EZH2 attenuates cerebral ischemia-reperfusion injury via regulating microRNA-30d-3p methylation and USP22.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief as there are concerns about the reliability of the results. Concerns have been raised about a portion of Figure 5B, 'DMSO' group appears to contain image similarities with Figure 4e, 'Inhibitor NC' group, published in Yang et al., 2021 doi: 10.1080/15384101.2020.1856498. A portion of Figure 5B, 'DZNeP+miR-30d-3p antagomir' group appears to contain image similarities with Figure 4e, 'Inhibitor NC' group, published in Yang et al., 2021. Figure 7/G western blot bands have the same eyebrow shaped phenotype as many other publications as detailed here (https://pubpeer.com/publications/B26AE47AC0E71E0EF339B40893B2C2).

A systematic review and meta-analysis of risk factors for unruptured intracranial aneurysm growth.

BACKGROUND: Many risk factors are associated with the growth of unruptured intracranial aneurysm; however, the effects of these risk factors on intracranial aneurysm growth remain poorly understood. Here, we performed a meta-analysis to evaluate the effects of these risk factors on intracranial aneurysm growth, incorporating different data types to provide comprehensive estimates of individual effects. METHODS: We searched the Cochrane Library, PubMed, Embase, and Web of Science for cohort studies analyzing risk factors for aneurysm growth prior to January 10, 2019. The hazard ratio (HR) and odds ratio (OR) with its 95% confidence interval (CI) were calculated to assess the effect of individual risk factors on intracranial aneurysm growth. Both univariate analysis (UVA) and multivariate analysis (MVA) were performed. Two reviewers independently assessed the quality of the trials and the associated data. All statistical analyses were performed using standard statistical procedures provided in Review Manager 5.2. RESULTS: We included 23 studies (N = 7208 participants) in this meta-analysis. A total of 944 patients (13.1%) experienced intracranial aneurysm growth during their follow-up times. Aneurysm size and smoking may have significant effects on the growth of intracranial aneurysm, with pooled ORs of 2.73 (95% CI 2.21-3.36; P < 0.00001) and 1.45 (95% CI 1.07-1.98; P = 0.02) respectively. However, our results indicated that subarachnoid hemorrhage (SAH) had a negative effect on the growth of intracranial aneurysm (OR 0.64; 95% CI 0.48-0.86; P = 0.003). Other risk factors such as irregular shape of intracranial aneurysm, female sex, and multiple aneurysms were inconsistent across studies due to differences in data types and effect estimates. CONCLUSIONS: Our meta-analysis identified aneurysm size and smoking as independent risk factors for the growth of intracranial aneurysm, while prior SAH had a negative effect on the growth of intracranial aneurysm. The roles of other risk factors for intracranial aneurysm growth were inconsistent, with further research necessary to assess fully the roles of these factors in disease outcomes.