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Original research
Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case–control study
  1. Guoli Duan1,
  2. Nan Lv1,
  3. Jianhua Yin2,
  4. Jinyu Xu1,
  5. Bo Hong1,
  6. Yi Xu1,
  7. Jianmin Liu1,
  8. Qinghai Huang1
  1. 1Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  2. 2Department of Epidemiology, Second Military Medical University, Shanghai, China
  1. Correspondence to Professor Jianmin Liu, Department of Neurosurgery, Changhai Hospital, Second Military Medical University, 168 Changhai Rd, Shanghai 200433, China; chstroke{at} Dr Q Huang


Objectives We evaluated the correlation between posterior communicating artery (PcomA) aneurysm rupture and morphological and hemodynamic parameters to assess related rupture risk indices.

Methods Six patients with PcomA aneurysms that ultimately ruptured (cases) were studied after initially being included in a prospective database including their three-dimensional (3D) imaging before rupture. For each case, four incidental stable unruptured aneurysms (controls) were randomly selected and matched based on clinical factors. The 3D images from all patients were reconstructed to establish the patient-specific model. Six morphologic parameters and three hemodynamic parameters were measured and calculated. A conditional logistic regression analysis was used to assess the individual risk of rupture.

Results The analysis demonstrated a larger aneurysm size (p=0.001), higher aspect ratio (p=0.018), ellipticity index (p<0.001), undulation index (p=0.005), percentage of low wall shear stress (WSS) area (LSA%) (p=0.010), and a lower normalized WSS (p=0.005) in the case group. The multivariate conditional logistic regression analysis demonstrated that only normalized WSS was significantly associated with the rupture of PcomA aneurysms (OR 0.151; 95% CI 0.025 to 0.914; p=0.040).

Conclusions Hemodynamics and morphology are closely associated with aneurysm rupture, and WSS may be a more reliable parameter characterizing the rupture status of PcomA aneurysms.

  • Aneurysm
  • Blood Flow
  • Angiography

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