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Hemorrhagic stroke
Original research
Morphological characteristics associated with ruptured intracranial vertebral artery dissecting aneurysms
  1. Jiangli Han1,
  2. Jigang Chen2,
  3. Xin Tong2,
  4. Mingyang Han1,
  5. Fei Peng2,
  6. Hao Niu2,
  7. Lang Liu1,
  8. Fei Liu1,3,
  9. Aihua Liu1,2,4
  1. 1 Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
  2. 2 Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  3. 3 Department of Neurosurgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
  4. 4 China National Clinical Research Centre for Neurological Diseases, Beijing, China
  1. Correspondence to Dr Aihua Liu, Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China; liuaihuadoctor{at}163.com; Dr Fei Liu, Department of Neurosurgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China; doctorlf{at}126.com

Abstract

Objective Morphological risk factors for the rupture of intracranial vertebral artery dissecting aneurysms (IVADAs) have not been well characterized. In this study, we aim to identify morphological characteristics associated with IVADA rupture.

Methods We conducted a retrospective study of 249 consecutive patients with single IVADAs (31 ruptured and 218 unruptured) admitted to Beijing Tiantan Hospital between January 2016 and December 2020. Various morphological parameters were measured using three-dimensional digital subtraction angiography images. Univariate and multivariate logistic regression analyses were performed to identify morphological characteristics associated with IVADA rupture.

Results Univariate regression analysis revealed that the coexistence of significant proximal and distal stenosis and posterior inferior cerebellar artery (PICA) involvement were associated with IVADA rupture, while the origin from the dominant vertebral artery was inversely associated with the rupture. Multivariate regression analysis demonstrated that the coexistence of significant proximal and distal stenosis (OR 22.00, 95% CI 5.60 to 86.70, p<0.001) and PICA involvement (OR 4.55, 95% CI 1.36 to 15.20, p=0.014) were independently associated with IVADA rupture.

Conclusion The coexistence of significant proximal and distal stenosis and PICA involvement were independently associated with IVADA rupture. These morphological characteristics may facilitate the assessment of rupture risk in patients with IVADAs.

  • Stenosis
  • Aneurysm
  • Angiography
  • Dissection
  • Artery

Data availability statement

Data are available upon reasonable request. The data supporting the findings of this study are available from the corresponding author upon reasonable request.

https://doi.org/10.1136/neurintsurg-2022-018744

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    Data availability statement

    Data are available upon reasonable request. The data supporting the findings of this study are available from the corresponding author upon reasonable request.

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    Footnotes

    • Contributors JH designed and conceptualized the study; collected, analyzed, and interpreted the data; and drafted the manuscript. JC and XT interpreted the data and revised the manuscript. MH, LL, FP and HN collected the data. AL acted as the guarantor, designed and conceptualized the study, and revised the manuscript. FL designed and conceptualized the study and revised the manuscript.

    • Funding This study was supported by the National Natural Science Foundation of China (81870944), the National Natural Science Foundation of China (81771233), Specific Research Projects for Capital Health Development (2018‐2‐2041), the Beijing Science and Technology Planning Project (Z181100009618035), the Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190501), and the Research and Promotion Program of Appropriate Techniques for Intervention of Chinese High-risk Stroke People (GN-2020R0007).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.