BACKGROUND AND PURPOSE: Understanding risk factors for intracranial aneurysm growth is important for patient management. We performed a meta-analysis examining risk factors for intracranial aneurysm growth in longitudinal studies and examined the association between aneurysm growth and rupture. MATERIALS AND METHODS: We searched the literature for longitudinal studies of patients with unruptured aneurysms. We examined the associations of demographics, multiple aneurysms, prior subarachnoid hemorrhage, family history of aneurysm or subarachnoid hemorrhage, smoking, and hypertension; and aneurysm shape, size, and location with aneurysm growth. We studied the association between aneurysm growth and rupture. A meta-analysis was performed by using a random-effects model by using summary statistics from included studies. RESULTS: Twenty-one studies including 3954 patients with 4990 aneurysms with 13,294 aneurysm-years of follow-up were included. The overall proportion of growing aneurysms was 3.0% per aneurysm-year (95% CI, 2.0%–4.0%). Patient risk factors for growth included age older than 50 years (3.8% per year versus 0.9% per year, P < .01), female sex (3.2% per year versus 1.3% per year, P < .01), and smoking history (5.5% per year versus 3.5% per year, P < .01). Characteristics associated with higher growth rates included cavernous carotid artery location (14.4% per year), nonsaccular shape (14.7% per year versus 5.2% per year for saccular, P < .01), and aneurysm size (P < .01). Aneurysm growth was associated with a rupture rate of 3.1% per year compared with 0.1% per year for stable aneurysms (P < .01). CONCLUSIONS: Observational evidence provided multiple clinical and anatomic risk factors for aneurysm growth, including age older than 50 years, female sex, smoking history, and nonsaccular shape. These findings should be considered when counseling patients regarding the natural history of unruptured intracranial aneurysms.

Significance: The use of increasingly sophisticated drugs to treat diseases like cancer often requires increasingly sophisticated delivery technologies, where multiple drugs often must be delivered simultaneously and in precise amounts; moreover, many drugs are hydrophobic and cannot be easily delivered. We report a simple and robust process to fabricate nanometer-sized polymersomes that can simultaneously deliver multiple therapeutics, both hydrophobic and hydrophilic, and have significantly improved drug-loading efficiencies over existing methods. We use these polymersomes to deliver a combination of hydrophobic anticancer drugs in a mouse model and see remarkable effectiveness against breast tumors. This work enables the use of previously undeliverable compounds in cancer therapy and forms a foundation for further development in a broad range of biomedical applications.

Thrombus enhancement can be used to predict cardioembolic and cryptogenic strokes and to identify thrombus enhancement–positive thrombi, which have a higher fibrin-to-platelet fraction and a lower ... Background Thrombus enhancement (TE) in large vessel occlusion in patients with acute ischemic stroke can be visualized with thin-slab maximum intensity projection (TS-MIP) image reconstruction of ...

BACKGROUND AND PURPOSE: Aneurysm recurrence is an innate problem after coiling, and the recurrence rate is higher in complicated aneurysms. We evaluated the feasibility and efficacy of using the Willis covered stent in treating recurrent aneurysms after coil embolization.