RT Journal Article
SR Electronic
T1 Low prevalence of fetal-type posterior cerebral artery in patients with basilar tip aneurysms
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 698
OP 701
DO 10.1136/neurintsurg-2016-012503
VO 9
IS 7
A1 Mariana C Diogo
A1 Isabel Fragata
A1 Sara P Dias
A1 Joana Nunes
A1 Jaime Pamplona
A1 João Reis
YR 2017
UL http://jnis.bmj.com/content/9/7/698.abstract
AB Background Basilar tip aneurysms (BTA) are multifactorial in origin, with luminal forces playing a major role in their formation. Considering the reduced hemodynamic stress on the basilar apex in the fetal-type posterior cerebral artery (fPCA), we hypothesize that BTA should be less common in patients with this variant.Objective To investigate, in a retrospective case–control study, the frequency of fPCA in patients with and without BTA.Materials and methods We collected clinical and imaging data from consecutive patients with BTA undergoing catheter angiography between July 2010 and July 2015, and from a randomly selected, age- and sex-matched non-BTA control population from our prospective database. Anatomical variants of the distal basilar artery region were assessed in the two groups and compared using parametric and non-parametric tests.Results Fifty-nine BTA cases and 337 controls were included. fPCA was present in 3% of patients with BTA and 23% in the control group (p<0.001; OR=0.11, 95% CI 0.03 to 0.48). Basilar tip disposition was cranial in 49% of BTA and 63% of non-BTA cases (p=0.04; OR=0.57, 95% CI 0.33 to 0.99); a caudal disposition was found in 24% and 6% of cases, respectively (p<0.001; OR=4.65, 95% CI 2.21 to 9.80).Conclusions We found a statistically significant association between the absence of fPCA and BTA. Our findings underline the importance of hemodynamic stress in the formation of intracranial aneurysms, and suggest that fPCA is a protective variant for formation of BTA.