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Original research
Clinical, morphological, and hemodynamic independent characteristic factors for rupture of posterior communicating artery aneurysms
  1. Ying Zhang1,
  2. Linkai Jing1,
  3. Jian Liu1,
  4. Chuanhui Li1,
  5. Jixing Fan1,
  6. Shengzhang Wang2,
  7. Haiyun Li3,
  8. Xinjian Yang1
  1. 1Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  2. 2Department of Mechanics and Engineering Science, Fudan University, Shanghai, China
  3. 3Department of Biomedical Engineering, Capital Medical University, Beijing, China
  1. Correspondence to Dr Xinjian Yang, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing 100050, China; yang-xj{at}163.net

Abstract

Objective To identify clinical, morphological, and hemodynamic independent characteristic factors that discriminate posterior communicating artery (PCoA) aneurysm rupture status.

Methods 173 patients with single PCoA aneurysms (108 ruptured, 65 unruptured) between January 2012 and June 2014 were retrospectively collected. Patient-specific models based on their three-dimensional digital subtraction angiography images were constructed and analyzed by a computational fluid dynamic method. All variables were analyzed by univariate analysis and multivariate logistic regression analysis.

Results Two clinical factors (younger age and atherosclerosis), three morphological factors (higher aspect ratio, bifurcation type, and irregular shape), and six hemodynamic factors (lower mean and minimum wall shear stress, higher oscillatory shear index, a greater portion of area under low wall shear stress, unstable and complex flow pattern) were significantly associated with PCoA aneurysm rupture. Independent factors characterizing the rupture status were identified as age (OR 0.956, p=0.015), irregular shape (OR 6.709, p<0.001), and minimum wall shear stress (OR 0.001, p=0.038).

Conclusions We combined clinical, morphological, and hemodynamic characteristics analysis and found the three strongest independent factors for PCoA aneurysm rupture were younger age, irregular shape, and low minimum wall shear stress. This may be useful for guiding risk assessments and subsequent treatment decisions for PCoA aneurysms.

  • Aneurysm
  • Blood Flow
  • Hemorrhage
  • Stroke
  • Angiography

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