Morphological Parameters and Anatomical Locations Associated with Rupture Status of Small Intracranial Aneurysms

Overview

Journal Sci Rep

Specialty Science

Date 2018 Apr 26

PMID 29691446

Citations 31

Authors

Zhihui Duan

Yuanhui Li

Sheng Guan

Congmin Ma

Yuezhen Han

Xiangyang Ren

Liping Wei

Wenbo Li

Jiyu Lou

Zhiyuan Yang

Affiliations

Soon will be listed here.

Abstract

Characterization of the rupture risk factors for small intracranial aneurysms (SIAs, ≤5 mm) is clinically valuable. The present study aims to identify image-based morphological parameters and anatomical locations associated with the rupture status of SIAs. Two hundred and sixty-three patients with single SIAs (128 ruptured, 135 unruptured) were included, and six morphological parameters, including size, aspect ratio (AR), size ratio (SR), height-width ratio (H/W), flow angle (FA) and aneurysm width-parent artery diameter ratio, and the aneurysm locations were evaluated using three-dimensional geometry, and were used to identify a correlation with aneurysm rupture. Statistically significant differences were observed between ruptured and unruptured groups for AR, SR, H/W, FA, and aneurysm locations, from univariate analyses. Logistic regression analysis further revealed that AR (p = 0.034), SR (p = 0.004), H/W (p = 0.003), and FA (p < 0.001) had the strongest independent correlation with ruptured SIAs after adjustment for age, gender and other clinical risk factors. A future study on a larger SIA cohort need to establish to what extent the AR, SR, H/W and FA increase the risk of rupture in patients with unruptured SIAs in terms of absolute risks.

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References

Baharoglu M, Schirmer C, Hoit D, Gao B, Malek A . Aneurysm inflow-angle as a discriminant for rupture in sidewall cerebral aneurysms: morphometric and computational fluid dynamic analysis. Stroke. 2010; 41(7):1423-30. DOI: 10.1161/STROKEAHA.109.570770. View

Jeong Y, Jung Y, Kim M, Eun C, Jang S . Size and location of ruptured intracranial aneurysms. J Korean Neurosurg Soc. 2009; 45(1):11-5. PMC: 2640825. DOI: 10.3340/jkns.2009.45.1.11. View

Meyers P, Schumacher H, Higashida R, Derdeyn C, Nesbit G, Sacks D . Reporting standards for endovascular repair of saccular intracranial cerebral aneurysms. J Neurointerv Surg. 2011; 2(4):312-23. DOI: 10.1136/jnis.2010.002337. View

Kashiwazaki D, Kuroda S . Size ratio can highly predict rupture risk in intracranial small (<5 mm) aneurysms. Stroke. 2013; 44(8):2169-73. DOI: 10.1161/STROKEAHA.113.001138. View

. Unruptured intracranial aneurysms--risk of rupture and risks of surgical intervention. N Engl J Med. 1998; 339(24):1725-33. DOI: 10.1056/NEJM199812103392401. View

Varble N, Rajabzadeh-Oghaz H, Wang J, Siddiqui A, Meng H, Mowla A . Differences in Morphologic and Hemodynamic Characteristics for "PHASES-Based" Intracranial Aneurysm Locations. AJNR Am J Neuroradiol. 2017; 38(11):2105-2110. PMC: 5819012. DOI: 10.3174/ajnr.A5341. View

Lin N, Ho A, Gross B, Pieper S, Frerichs K, Day A . Differences in simple morphological variables in ruptured and unruptured middle cerebral artery aneurysms. J Neurosurg. 2012; 117(5):913-9. DOI: 10.3171/2012.7.JNS111766. View

Carter B, Sheth S, Chang E, Sethl M, Ogilvy C . Epidemiology of the size distribution of intracranial bifurcation aneurysms: smaller size of distal aneurysms and increasing size of unruptured aneurysms with age. Neurosurgery. 2006; 58(2):217-23. DOI: 10.1227/01.NEU.0000194639.37803.F8. View

Raghavan M, Ma B, Harbaugh R . Quantified aneurysm shape and rupture risk. J Neurosurg. 2005; 102(2):355-62. DOI: 10.3171/jns.2005.102.2.0355. View

10.

Rinkel G, Djibuti M, Algra A, van Gijn J . Prevalence and risk of rupture of intracranial aneurysms: a systematic review. Stroke. 1998; 29(1):251-6. DOI: 10.1161/01.str.29.1.251. View

11.

Juvela S, Poussa K, Lehto H, Porras M . Natural history of unruptured intracranial aneurysms: a long-term follow-up study. Stroke. 2013; 44(9):2414-21. DOI: 10.1161/STROKEAHA.113.001838. View

12.

Sato K, Yoshimoto Y . Risk profile of intracranial aneurysms: rupture rate is not constant after formation. Stroke. 2011; 42(12):3376-81. DOI: 10.1161/STROKEAHA.111.625871. View

13.

Zheng Y, Xu F, Ren J, Xu Q, Liu Y, Tian Y . Assessment of intracranial aneurysm rupture based on morphology parameters and anatomical locations. J Neurointerv Surg. 2016; 8(12):1240-1246. DOI: 10.1136/neurintsurg-2015-012112. View

14.

Matsukawa H, Uemura A, Fujii M, Kamo M, Takahashi O, Sumiyoshi S . Morphological and clinical risk factors for the rupture of anterior communicating artery aneurysms. J Neurosurg. 2012; 118(5):978-83. DOI: 10.3171/2012.11.JNS121210. View

15.

Kassell N, Torner J . Size of intracranial aneurysms. Neurosurgery. 1983; 12(3):291-7. DOI: 10.1227/00006123-198303000-00007. View

16.

Nahed B, DiLuna M, Morgan T, Ocal E, Hawkins A, Ozduman K . Hypertension, age, and location predict rupture of small intracranial aneurysms. Neurosurgery. 2005; 57(4):676-83. View

17.

Dolati P, Pittman D, Morrish W, Wong J, Sutherland G . The Frequency of Subarachnoid Hemorrhage from Very Small Cerebral Aneurysms (< 5 mm): A Population-Based Study. Cureus. 2015; 7(6):e279. PMC: 4494560. DOI: 10.7759/cureus.279. View

18.

Ohashi Y, Horikoshi T, Sugita M, Yagishita T, Nukui H . Size of cerebral aneurysms and related factors in patients with subarachnoid hemorrhage. Surg Neurol. 2004; 61(3):239-45. DOI: 10.1016/S0090-3019(03)00427-0. View

19.

Dhar S, Tremmel M, Mocco J, Kim M, Yamamoto J, Siddiqui A . Morphology parameters for intracranial aneurysm rupture risk assessment. Neurosurgery. 2008; 63(2):185-96. PMC: 2570753. DOI: 10.1227/01.NEU.0000316847.64140.81. View

20.

Ujiie H, TAMANO Y, Sasaki K, Hori T . Is the aspect ratio a reliable index for predicting the rupture of a saccular aneurysm?. Neurosurgery. 2001; 48(3):495-502; discussion 502-3. DOI: 10.1097/00006123-200103000-00007. View