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There is an increasing number of studies on the transradial approach (TRA) for carotid artery stenting. We aimed to summarize the published data on TRA vs the transfemoral approach (TFA). We searched Science Direct, Embase, PubMed, and Web of Science databases for the relevant literature. Primary outcomes included surgical success and cardiovascular and cerebrovascular complication rates; secondary outcomes included the rates of vascular access-related and other complications. We also compared the crossover rate, success rate, and complications between TRA and TFA carotid stenting. This is the first such meta-analysis regarding TRA and TFA. Twenty studies on TRA carotid stenting were included (n = 1300). Among 19 studies, the success rate of TRA carotid stenting was.951 (95% confidence interval [CI]:.926–.975); death rate was.022 (.011–.032); stroke rate was.005 (.001–.008); radial artery occlusion rate was.008 (.003–.013); and forearm hematoma rate was.003 (−.000 to.006). Among 4 studies comparing TRA and TFA, the success rate was lower (odds ratio:.02; 95% CI:.00–.23) and crossover rate was higher (odds ratio: 40.16; 95% CI: 4.41–365.73) with TRA. Thus, transradial neuro-interventional surgery has a lower success rate than TFA. [ABSTRACT FROM AUTHOR]

Objective: Unicystic ameloblastomas are a variant of ameloblastoma with a definite recurrence rate because of the biological behaviours of the tumour. The risk factors associated with disease recurrence were analysed in this retrospective study. Methods: A total of 132 patients with primary unicystic ameloblastoma reported in a tertiary hospital from 2005 to 2015 were analysed to identify the clinic‐pathological and radiological factors associated with recurrence using univariate and multivariate Cox regression analyses. Results: The mean volume was 30.54cm3 ± 12.55 cm3, and this value differed significantly according to recurrence (p < 0.001). Root resorption and bone cortex/soft tissue invasion were also significantly associated with recurrence among unicystic ameloblastoma patients (p = 0.017 vs. p < 0.001, respectively). A new stage classification system was developed to predict disease recurrence of patients. The multivariate Cox regression analysis revealed that the new stage classification system was the only predictor of disease recurrence in unicystic ameloblastoma patients (p < 0.001), regardless of root resorption, position and site characteristics. Conclusions: Volume, root resorption and bone cortex/soft tissue invasion were risk factors for disease recurrence among unicystic ameloblastoma patients. The new stage classification was an independent predictor of disease recurrence in patients with unicystic ameloblastoma. [ABSTRACT FROM AUTHOR]

Background: Comorbidity of Myasthenia gravis (MG) and Graves' disease (GD) in treated HIV‐infected individuals has rarely been described and little study has been done on the link between HIV‐related immune reconstitution and autoimmune diseases occurring post antiretroviral therapy. Case Presentation: Here we report on a 33‐year‐old Chinese man with HIV infection who had been virologically suppressed since 2018. The patient was diagnosed with GD and was treated in 2020. Early in 2022, he developed fluctuating weakness and fatigue involving the bilateral extraocular muscles and limbs. With a positive neostigmine test, he was considered to have MG, but showed a poor response to oral medication. After multiple failed medication attempts, a thymectomy was finally performed to resolve his symptoms. The consecutive onset of immunological events may have partially resulted from immune reconstitution after viral control. Conclusions: This is a rare case of HIV‐related immune reconstitution‐associated autoimmune disease (IRAD) with comorbidity of MG and GD which was reported initially. Cooperation with multidisciplinary teams is essential to avoid misdiagnosis and to promote the overall health of HIV‐infected patients. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSIs) pose a significant complication following laparoscopic urological surgeries, impacting patient recovery and healthcare resources. Understanding the pathogen distribution and identifying associated risk factors for SSIs is critical for improving surgical outcomes. A retrospective analysis was performed on 90 patients, from March 2020 to June 2023, to investigate the risk factors and pathogen profiles in SSIs post‐laparoscopic urological procedures. Patients with documented infections were compared to a control group without SSIs. Data on demographics, comorbidities and perioperative variables were collected. Pathogens were identified using the VITEK‐2 Compact system. Statistical analyses included univariate and multivariate logistic regression models. Upon evaluation, demographic and clinical characteristics showed no significant variance in patients with SSIs compared to those without such infections. The predominant pathogen identified was Escherichia coli. Administration of prophylactic antibiotics correlated with a reduced incidence of SSIs, whereas an array of risk factors including surgery duration of 2 h or more, anaemia, white blood cell counts exceeding 10 × 109/L, a history of urinary tract infections, the presence of diabetes mellitus and incidences of urinary leakage post‐surgery were identified as contributors to a heightened risk of SSIs. Prophylactic antibiotics serve as a protective factor against SSIs, whereas several modifiable risk factors, including operation duration, anaemia, elevated leukocytes, history of urinary infections, diabetes and urinary leakage, contribute to the increased risk. [ABSTRACT FROM AUTHOR]

Objectives: Tracheobronchial foreign body aspiration (TFBA) is a major cause of accidental death in children. Lower respiratory tract infection (LRTI) may be caused by TFBA, but there are few reports about LRTI associated with TFBA. This study collected TFBA cases in our hospital to analyze LRTI and determine its risk factors. Methods: A total of 194 children who underwent tracheobronchial foreign body (TFB) extraction in The Children's Hospital of Zhejiang University School of Medicine from June 2019 to April 2020 were enrolled. CT chest is routinely used in the workup of suspected airway FB at our institution to evaluate for patients, a FB was already highly suspected. The retention time was defined as from the time of TFB inhalation or presentation (if there was no history of TFBA) to the time of TFB removal. General characteristics including weight, clinical symptoms, operative records, cervicothoracic CT, retention time, type of TFB and postoperative hospitalization time were collected. Chi-square tests, rank sum tests and multivariate logistic regression analyses were performed. Results: The incidence of LRTI was 46.6%, 68.6%, and 68.6% when the retention time was within 24 hours, between 24 hours and up to 1 week and more than 1 week, respectively. Postoperative hospitalization time of LRTI group was significantly longer than that of non-LRTI group. Findings for cervicothoracic CT as pneumonia, emphysema, atelectasis meant more serious clinical manifestations and the retention time was longer in the LRTI group than in the non-LRTI group. There was a positive correlation between the retention time of a TFB and LRTI in multivariate logistic regression analysis. Conclusions: The incidence of LRTI caused by TFBA is high. LRTI is association with longer postoperative hospitalization time. The TFB retention time is an independent risk factor for LRTI. If a patient presents with significant LRTI symptoms, a course of steroids and antibiotics maybe a safer approach rather than proceeding immediately with bronchoscopic removal. [ABSTRACT FROM AUTHOR]

In recent years, single-cell RNA sequencing analyses have identified multiple subpopulations of these cells in brains harboring Alzheimer's disease (AD) pathology. Consequently, ablation of IFN-I receptor gene selectively from neural cells reduces A plaques in a mouse AD model [[6]], affirming a feedforward loop whereby plaque-induced inflammation further exacerbates AD pathology. Nevertheless, the IFN-II receptor gene dose is similarly elevated as that of IFNARs in DS [[10]], and IFN-II was shown to counteract the pathogenic effect of IFN-I in aging brain [[15]]. Reactive microglia accompany many neurodegenerative conditions and their contribution to disease progression is increasingly appreciated. [Extracted from the article]

Background. Esophageal squamous cell carcinoma (ESCC) is a common second primary neoplasia in patients with a history of head and neck squamous cell carcinoma (HNSCC). The aim of this study was to provide further information and novel insights into the risk factors for ESCC in patients with HNSCC. Methods. We retrospectively analyzed 98 HNSCC patients diagnosed from 2007 to 2017, 30 HNSCC patients suffering from ESCC, who had undergone endoscopic examination because of positive imaging examinations or symptoms, and 68 HNSCC patients who had no ESCC occurrence for at least six years post-HNSCC diagnosis. Associated clinicopathological data and lifestyle information of the ESCC group and the without ESCC group were collected, and a case-control study of risk factors was analyzed between the two groups. Results. The majority (83.4%) of the cases with HNSCC esophageal cancers were male patients over 50 years. We established that 93.75% (30/32) of the ESCC occurred within six years after HNSCC diagnosis. HNSCC location, stage, and radiotherapy history had no significant association with the development of ESCC. High Ki67 labeling index (Ki67 LI) (>46) patients tended to be 3.1 times (95% CI = 1.3–7.6) more likely to develop ESCC compared to low Ki67 LI (≤45) patients (P < 0.05). Drinkers with alcohol flushing response were at a 3.3 times higher risk to have ESCC (95% CI = 1.0–10.4) than drinkers without flush response (P < 0.05). Conclusions. HNSCC patients, especially drinkers with an alcohol flushing response, as well as those with high Ki67 LI of HNSCC tissue, were more likely to develop ESCC. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer death worldwide. Data on the effectiveness of one-off low-dose CT (LDCT) in reducing lung cancer mortality and all-cause mortality are needed to inform screening programmes in countries with limited medical resources. We aimed to evaluate the effectiveness of one-off LDCT screening in the early detection of lung cancer in China. A multicentre, population-based, prospective cohort study was done in 12 cities of eight provinces across China, recruiting individuals aged 40–74 years who were asymptomatic for lung cancer with no lung cancer history. Participants were classified as at high risk or low risk of lung cancer using a sex-specific risk score that incorporated cigarette smoking, level of physical activity, occupational exposures, history of chronic respiratory diseases, family history of lung cancer, diet, and passive smoking (women only). Participants at high risk were invited for a one-off LDCT scan and were classified into screened and non-screened groups on the basis of whether or not they had the scan. Lung cancer incidence density, lung cancer mortality, and all-cause mortality were calculated for the screened and non-screened groups. The effectiveness of a one-off LDCT scan was evaluated by a comparison of the screened and non-screened groups in terms of lung cancer mortality and all-cause mortality in the period from cohort entry until administrative censoring (June 20, 2020). Inverse probability weighting was adopted to account for potential imbalanced factors between the two groups and Cox proportional hazards model was used to estimate the weighted associations between mortality and one-off LDCT scans. Between Feb 19, 2013, and Oct 31, 2018, 1 032 639 individuals were assessed for eligibility. 1 016 740 participants were enrolled in the study, of whom 3581 had a lung cancer diagnosis after a median follow-up of 3·6 years (IQR 2·8–5·1). Among the 223 302 participants at high risk, 79 581 (35·6%) had an LDCT scan (screened group) and 143 721 (64·4%) did not (non-screened group). After inverse probability weighting, lung cancer incidence density was 47·0% higher (hazard ratio 1·47 [95% CI 1·27–1·70]; p<0·0001), lung cancer mortality was 31·0% lower (0·69 [95% CI 0·53–0·92]; p=0·010) and all-cause mortality was 32·0% lower (0·68 [0·57–0·82]; p<0·0001) for participants in the screened group compared with those in the non-screened group. One-off LDCT screening was associated with significantly lower lung cancer mortality and all-cause mortality in a large population in China. Our results point to the promise of one-off LDCT screening in countries with limited medical resources. Further studies are needed to explore interactions by subgroup—including sex, age, smoking status, and economic status—to develop population-specific screening strategies. Ministry of Finance and National Health Commission of the People's Republic of China. For the Chinese translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Background: Screening with low‐dose computed tomography (LDCT) is an efficient way to detect lung cancer at an earlier stage, but has a high false‐positive rate. Several pulmonary nodules risk prediction models were developed to solve the problem. This systematic review aimed to compare the quality and accuracy of these models. Methods: The keywords "lung cancer," "lung neoplasms," "lung tumor," "risk," "lung carcinoma" "risk," "predict," "assessment," and "nodule" were used to identify relevant articles published before February 2021. All studies with multivariate risk models developed and validated on human LDCT data were included. Informal publications or studies with incomplete procedures were excluded. Information was extracted from each publication and assessed. Results: A total of 41 articles and 43 models were included. External validation was performed for 23.2% (10/43) models. Deep learning algorithms were applied in 62.8% (27/43) models; 60.0% (15/25) deep learning based researches compared their algorithms with traditional methods, and received better discrimination. Models based on Asian and Chinese populations were usually built on single‐center or small sample retrospective studies, and the majority of the Asian models (12/15, 80.0%) were not validated using external datasets. Conclusion: The existing models showed good discrimination for identifying high‐risk pulmonary nodules, but lacked external validation. Deep learning algorithms are increasingly being used with good performance. More researches are required to improve the quality of deep learning models, particularly for the Asian population. [ABSTRACT FROM AUTHOR]

Background: To investigate the association between the risk of lung cancer and short‐term body mass index (BMI) changes in male never‐smokers of a large population‐based prospective study. Methods: A total of 37,085 male never‐smokers from Kailuan cohort with at least ≥2 BMI measurements were recruited in the present study. The BMI change in the follow‐up was calculated as the annual percent change between BMI at last examination and that at baseline, and categorized into five groups: stable (−0.1 to <0.1 kg/m2/year), minor loss (−1.0 to <0.1 kg/m2/year) or gain (0.1 to <1.0 kg/m2/year), and major loss (<−1.0 kg/m2/year) or gain (≥1.0 kg/m2/year). The hazards ratios (HRs) and its 95% confidence intervals (CI) were estimated using Cox regression models. Results: During a median follow‐up of 5.16 years, 224 lung cancer cases were identified. We found a U‐shaped association between BMI changes and lung cancer risk. Compared to men with stable BMI, those with major loss had a nearly twofold higher risk of lung cancer (HR = 1.97, 95% CI: 1.12–3.45), as well as those with major gain had more than twofold higher risk of lung cancer (HR = 2.15, 95% CI: 1.15–4.02). The associations existed when the analysis was stratified by BMI, waist circumference and blood lipids, and lipoproteins concentration at baseline examination. Conclusions: The dramatic changes in BMI, both gain and loss, might increase lung cancer risk. The control of body weight would be a potential way for lung cancer prevention especially for the nonsmokers. [ABSTRACT FROM AUTHOR]

Diabetes is directly related to the risk of breast cancer (BC) occurrence and worsened BC prognosis. Currently, there are no specific treatments for diabetes‐associated BC. This paper aims to understand the fundamental mechanisms of diabetes‐induced BC progression and to develop personalized treatments. It reports a metabolic reprogramming strategy (MRS) that pharmaceutical induction of glucose import and glycolysis with metformin and NF‐κB inhibitor (NF‐κBi) while blocking the export of excessive lactate via inhibiting monocarboxylate transporter 4 (MCT4) leads to a metabolic crisis within the cancer cells. It demonstrates that the MRS shifts the metabolism of BC cells toward higher production of lactate, blocks lactate secretion, prompts intracellular acidification and induces significant cytotoxicity. Moreover, a novel MCT4 inhibitor CB‐2 has been identified by structure‐based virtual screening. A triple combination of metformin, CB‐2, and trabectedin, a drug that impedes NF‐κB signaling, strongly inhibits BC cells. Compared to normal glucose condition, MRS elicits more potent cancer cell‐killing effects under high glucose condition. Animal model studies show that diabetic conditions promote the proliferation and progression of BC xenografts in nude mice and that MRS treatment significantly inhibits HG‐induced BC progression. Therefore, inhibition of MCT4 combined with metformin/NF‐κBi is a promising cancer therapy, especially for diabetes‐associated BC. [ABSTRACT FROM AUTHOR]

Objective: Flares of lupus nephritis (LN) are frequent and associated with impaired renal prognosis. One major management obstacle in LN flare is the lack of effective methods to identify at‐risk patients earlier in their disease course. This study was undertaken to test the utility of measurement of urinary matrix metalloproteinase 7 (MMP‐7) for the dynamic surveillance of renal disease activity and prediction of renal flares in LN. Methods: A prospective, 2‐stage cohort study was performed in patients with LN. Urinary MMP‐7 levels at the time of biopsy were evaluated in 154 patients with newly diagnosed LN in 2 independent cohorts. Urinary MMP‐7 levels were assessed for correlation with renal histologic activity. Furthermore, after a minimum period of 12 months of renal disease remission, urinary MMP‐7 levels were monitored bimonthly for 2 years in 65 patients with LN. The association between urinary MMP‐7 levels and development of LN flare was analyzed. Results: Urinary MMP‐7 levels were elevated in patients with LN. A higher urinary MMP‐7 level in LN was associated with greater renal histologic activity. As a marker for identifying LN patients with more severe renal histologic activity (i.e., a histologic activity index of ≥7), the level of urinary MMP‐7 outperformed other clinical markers and improved their predictive performance, thus linking urinary MMP‐7 levels to renal disease activity. Furthermore, among patients who had follow‐up measurements of urinary MMP‐7 after achievement of long‐term remission of renal disease activity, an elevated urinary MMP‐7 level during follow‐up was independently associated with an increased risk of LN flare. This elevation in the urinary MMP‐7 level hinted at the risk of an LN flare at an earlier time point prior to indications using conventional laboratory measures. Thus, use of the urinary MMP‐7 level in conjunction with other clinical measures improved the prognostic value for prediction of an LN flare. Conclusion: Urinary MMP‐7 levels in LN are correlated with renal histologic activity. An elevated urinary MMP‐7 level detected after achievement of long‐term renal disease remission is associated with a higher risk of incident renal flare in patients with LN. [ABSTRACT FROM AUTHOR]

Background: The presence of simple renal cyst (SRC) has been associated to renal dysfunction, but the results were inconsistent. Accordingly, we conducted a longitudinal cohort study to explore the association between SRC and kidney damage. Methods: A total of 4274 adults (aged 45.4 ± 13.6 years) without chronic kidney disease at baseline were enrolled in 2008. SRC was assessed by ultrasonography. Logistic regression analysis were applied to explore the relationships between SRC and indicators of kidney damage (proteinuria and renal insufficiency), and also with relatively rapid decline in renal function (defined as the lowest quartile of △eGFR). Results: During 5 years of follow-up, participants in the SRC group had higher incidence of proteinuria (5.2% versus 2.4%, p = 0.004) and renal insufficiency (3.8% versus 0.97%, p < 0.001) compared with control group. SRC was correlated with proteinuria (OR 2.24; 95% CI 1.34–3.75) and renal insufficiency (OR 4.0; 95% CI 2.11–7.58) in univariable analysis, despite that the correlation was not significant after adjusted for traditional kidney disease risk factors. Furthermore, after adjusted for potential confounders, maximum diameter of the cyst (≥2.2 cm) was significantly associated with rapid decline in renal function (OR 2.19; 95% CI 1.24–3.87). Conclusions: Participants with SRC may be associated with higher incidence of proteinuria and renal insufficiency. This relationship may be obscured by age and other traditional risk factors. Higher diameter of the cysts contributed to more rapid decline in renal function of SRC participants. [ABSTRACT FROM AUTHOR]

Purpose: Patients with hematological malignancies (HMs) are at a higher risk for bloodstream infections (BSIs), which pose significant burden on morbidity and mortality. Better risk stratification helps in medical decision making, increasing efficiency and reducing economic burden. The aim of this study was to develop and validate a reliable prediction model which can be used to identify HM patients at higher risk for BSIs.Methods: We conducted a retrospective cohort study in three university-affiliated hospitals in Hunan Province, China, from January 2010 to April 2015. A total of 521 HMs patients with BSIs were finally included in this study and were divided into the derivation set and validation set. Survivors and non-survivors were compared to identify the predictors of 30-day mortality.Results: The multivariate analysis yielded the following significant mortality-related risk factors: age > 60 years (95% CI 1.047-5.474), relapsed or uncontrolled malignancy (95% CI 2.043-14.029), Pitt bacteremia score > 3 (95% CI 1.614-6.35), prolonged neutropenia (95% CI 1.181-5.824), use of vasopressors (95% CI 3.009-12.210), acute respiratory failure (95% CI 3.061-14.911), fungemia (95% CI 1.334-12.121), inadequate antibiotic treatment (95% CI 1.682-7.591), albumin < 30 g/L (95% CI 1.030-3.446), TBil > 34.2 µmol/L (95% CI 1.109-5.438). In both derivation and validation sets, our model showed reliable prediction value with areas under the receiver operating curve of 0.876 and 0.873.Conclusions: The risk factors in this study have the ability to identify patients with HMs and BSIs at high risk for mortality. Our model provides an excellent foundation for predicting 30-day morality in HM patients suffering from BSI and helps target high-risk patients for management decision making. [ABSTRACT FROM AUTHOR]

Aims: Acute kidney injury (AKI) is increasingly recognized as a major risk factor leading to progression to chronic kidney disease (CKD). However, the diagnostic tools for predicting AKI to CKD progression are particularly lacking. Here, we tested the utility of contrast-enhanced ultrasound (CEUS) for predicting progression to CKD after AKI by using both mild (20-min) and severe (45-min) bilateral renal ischemia-reperfusion injury mice. Results: Renal perfusion measured by CEUS reduced to 25% ± 7% and 14% ± 6% of the pre-ischemic levels in mild and severe AKI 1 h after ischemia ( p < 0.05). Renal perfusion returned to pre-ischemic levels 1 day after mild AKI followed by restoration of kidney function. However, severe AKI caused persistent renal perfusion impairment (60% ± 9% of baseline levels) accompanied by progressive renal fibrosis and sustained decrease in renal function. Renal perfusion at days 1-21 significantly correlated with tubulointerstitial fibrosis 42 days after AKI. For predicting renal fibrosis at day 42, the area under the receiver operating characteristics curve of renal perfusion impairment at day 1 was 0.84. Similar changes in the renal image of CEUS were observed in patients with AKI-CKD progression. Innovation: This study demonstrates that CEUS enables dynamic and noninvasive detection of renal perfusion impairment after ischemic AKI and the perfusion abnormalities shown by CEUS can early predict the progression to CKD after AKI. Conclusions: These results indicate that CEUS enables the evaluation of renal perfusion impairment associated with CKD after ischemic AKI and may serve as a noninvasive technique for assessing AKI-CKD progression. Antioxid. Redox Signal. 27, 1397-1411. [ABSTRACT FROM AUTHOR]

Purpose: Hypoxia and its consequences at the molecular level promote tumour progression and affect patient prognosis. One of the main early cellular events evoked by hypoxia is induction of hypoxia-inducible factor 1 (HIF-1) and subsequent upregulation of vascular endothelial growth factor (VEGF). In this study we sought to determine whether hypoxia detected by F-fluoromisonidazole (FMISO) PET accurately reflects the expression of HIF-1α and VEGF in the tumour and can be used as a biomarker of antiangiogenic treatment and as a prognostic factor in newly diagnosed and recurrent malignant gliomas. Methods: Enrolled in this study were 32 patients with newly diagnosed glioma and 16 with recurrent glioma of grade III or grade IV. All the patients had undergone FMISO PET preoperatively. The maximum tumour-to-blood FMISO activity ratio (T/B) was used to evaluate the degree of tumour hypoxia and the hypoxic volume (HV) was calculated using a tumour-to-blood FMISO uptake ratio of ≥1.2. Immunohistochemical expressions of HIF-1α and VEGF were evaluated semiquantitatively using the immunoreactivity score (IRS, scores 0 to 12) and the correlation was examined between IRS of HIF-1α or VEGF and FMISO uptake of the tumour (SUV) using navigation-based sampling. Survival was estimated using the Kaplan-Meier method in relation to the T/B and the HV. Results: The T/B and the HV in grade IV gliomas were significantly higher than in grade III gliomas ( P < 0.01 and P < 0.01, respectively). Moderate to strong HIF-1α and VEGF expression was observed in the majority of malignant gliomas. The IRS of HIF-1α and VEGF in the tumour were not significantly different between grade III and grade IV gliomas. The IRS of HIF-1α in the tumour did not correlate with the SUV of FMISO in either newly diagnosed or recurrent glioma. There was a significant but weak correlation between the IRS of VEGF and the SUV of FMISO in newly diagnosed glioma, but not in recurrent glioma. The overall survival time in patients with a small HV and a low FMISO T/B was significantly longer than in those with a large HV and a high FMISO T/B ( P < 0.01 and P < 0.05, respectively). Conclusion: Preoperative FMISO uptake is significantly correlated with the expression of VEGF in the tumour and might be used as a biomarker of antiangiogenic treatment in newly diagnosed malignant gliomas. However, caution is required because the correlation was weak and there was a large overlap of FMISO uptake between glioma with high and low VEGF expression. In addition, hypoxia determined by FMISO PET appears to be a suitable biomarker for predicting a highly malignant tumour and a poor prognosis in patients with malignant glioma. [ABSTRACT FROM AUTHOR]

Background The management of small, unruptured intracranial aneurysms is still controversial. Given the distinctive natural history of aneurysm at different locations, location-specific analysis might be a reasonable approach. This study aimed to investigate morphological discriminators for rupture status by focusing on only posterior communicating artery (PcomA) aneurysms smaller than 7 mm. Methods In 108 small PcomA aneurysms (68 ruptured, 40 unruptured), clinical and morphological characteristics were compared between the ruptured and unruptured groups. Multivariate logistic regression analysis was performed to determine the independent predictors for the rupture status of small PcomA aneurysms. Results None of the clinical characteristics were significantly different between the ruptured and unruptured groups ( P > 0.05). The ruptured group revealed a significantly larger size ( P = 0.009), aspect ratio ( P = 0.009), size ratio ( P = 0.002), dome-to-neck ratio ( P = 0.002), inflow angle ( P < 0.001), and proportion of bleb formation ( P = 0.039). Bottleneck factor ( P = 0.154), diameter of PcomA ( P = 0.302), and fetal-type PcomA ( P = 0.832) showed no significance. With multivariate analyses, size ratio ( P = 0.012) and inflow angle ( P = 0.001) were shown to be independently associated with the rupture status of small PcomA aneurysms. Conclusions Morphological characteristics were closely related with the rupture status of small PcomA aneurysms. Size ratio and inflow angle were independent risk factors for rupture and might be useful in clinical risk stratification of small PcomA aneurysms. [ABSTRACT FROM AUTHOR]