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.
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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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.
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