RT Journal Article
SR Electronic
T1 Geometric variations associated with posterior communicating artery aneurysms
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 1049
OP 1052
DO 10.1136/neurintsurg-2020-017062
VO 13
IS 11
A1 Jian Zhang
A1 Anil Can
A1 Pui Man Rosalind Lai
A1 Srinivasan Mukundan, Jr.
A1 Victor M Castro
A1 Dmitriy Dligach
A1 Sean Finan
A1 Vivian Gainer
A1 Nancy Shadick
A1 Guergana Savova
A1 Shawn N Murphy
A1 Tianxi Cai
A1 Scott T Weiss
A1 Rose Du
YR 2021
UL http://jnis.bmj.com/content/13/11/1049.abstract
AB Background Hemodynamic stress, conditioned by the morphology of the surrounding vasculature, plays an important role in aneurysm formation. Our goal was to identify image-based location-specific parameters that are associated with posterior communicating artery (PCoA) aneurysms.Methods Three-dimensional morphological parameters obtained from CT angiography or digital subtraction angiography from 187 patients with unilateral PCoA aneurysms, diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016, were evaluated. In order to control for genetic and clinical risk factors, we chose the contralateral unaffected PCoA as a control group. We examined diameters and angles of the surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with small aneurysms (≤5 mm) only and an unmatched analysis of 432 PCoA aneurysms and 197 control patients without PCoA aneurysms were also performed.Results In a multivariable conditional logistic regression model we showed that smaller diameter size ratio (OR 1.45×10−5, 95% CI 1.12×10−7 to 1.88×10−3) and larger daughter-daughter angle (OR 1.04, 95% CI 1.02 to 1.07) were significantly associated with PCoA aneurysm presence after correcting for other variables. In subgroup analyses of small aneurysms (≤5 mm) and in an unmatched analysis the significance and direction of these results were preserved.Conclusions Larger daughter-daughter angles and smaller diameter size ratio are significantly associated with the presence of PCoA aneurysms. These simple parameters can be utilized to guide the risk assessment for the formation of PCoA aneurysms in high risk patients.Data are available upon reasonable request; email: rdu@bwh.harvard.edu