Registry: female sex, balloon remodeling, ACom/PCom location raise rupture risk during unruptured aneurysm treatment

Rupture during unruptured aneurysm endovascular treatment occurred in 1.21% (164/13,524), with 17.9% poor 30-day outcome. Independent risks: female sex (OR 2.27), balloon remodeling (OR 1.43), ACom (OR 2.40), PCom (OR 1.58); retreatment reduced risk (OR 0.36).

• Nationwide Japanese registry (JR-NET4) included 13,524 endovascular procedures for unruptured intracranial aneurysms; intraprocedural rupture occurred in 164 (1.21%).
• Independent predictors were female sex (OR 2.27, 95% CI 1.48–3.50), balloon remodeling catheter use (OR 1.43, 95% CI 1.03–1.99), anterior communicating artery aneurysm (OR 2.40, 95% CI 1.55–3.70), and posterior communicating artery aneurysm (OR 1.58, 95% CI 1.03–2.44); retreatment was associated with lower risk (OR 0.36, 95% CI 0.16–0.82).
• Cases with intraprocedural rupture had 17.9% poor 30-day clinical outcome and 4.88% 30-day mortality.

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