Morphometry and hemodynamics of posterior communicating artery aneurysms: Ruptured versus unruptured |
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| Affiliation: | 1. Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China;2. PKU-HKUST Shenzhen-Hongkong Institution, Shenzhen, China;3. Department of Interventional Vascular Surgery, Affiliated Hospital of Hebei University, Baoding, China;4. Department of Radiology, Affiliated Hospital of Hebei University, Baoding, China;5. Shenzhen Graduate School, Peking University, Shenzhen, China;1. Department of Aerospace Engineering and Engineering Mechanics, University of Texas at Austin, TX, USA;2. Department of Biomedical Engineering, University of Texas at Austin, TX, USA;3. Meijer Heart and Vascular Institute at Spectrum Health, Michigan, MI, USA;4. Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland;5. Institute for Computational Engineering and Sciences, University of Texas at Austin, TX, USA;1. Department of Neurosurgery, the Second Hospital, Shandong University, No. 247 Beiyuan Street, Jinan 250033, China;2. Center of Evidence-based Medicine, the Second Hospital, Shandong University, No. 247 Beiyuan Street, Jinan 250033, China;3. Department of Neurosurgery, Qilu Hospital, Shandong University, No. 758 Hefei Road, Qingdao, Shandong 266000 China;1. Neurosurgery Department, Rouen University Hospital, 1, rue de Germont, 76031 Rouen, France;2. Neurosurgery Department, Strasbourg University Hospital, 67098 Strasbourg, France;1. Department of Neurosurgery, Chinese PLA General Hospital, Haidian District, Beijing, China;2. Department of Neurosurgery, Chinese PLA NO. 180 Hospital, Fengze District, Quanzhou City, Fujian Province, China;3. Department of Endocrinology, Chinese PLA Rocket Force General Hospital, Xicheng District, Beijing, China;4. Department of Radiology, Chinese PLA General Hospital, Haidian District, Beijing, China |
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| Abstract: | Posterior communicating artery (PCoA) aneurysms frequently rupture in small size (<7 mm). The aim of the study is to demonstrate morphometric and hemodynamic analyses in ruptured and unruptured PCoA aneurysms to improve predictive accuracy for rupture. Geometrical models were reconstructed from rotational DSA images of 57 ruptured and 22 unruptured side-wall PCoA aneurysms, which were classified into four two-dimensional (2D) groups by a combination of H/D and H/S ratios (H: dome height, D: dome diameter, and S: semi-axis height). Surface area ratio (SAR) of low time-averaged wall shear stress (TAWSS, ≤4 dynes cm−2) and high oscillatory shear index (OSI, ≥0.15) were computed in aneurysms. We hypothesized that a two-step analysis method, i.e., one-dimensionally morphometric and hemodynamic analyses in each 2D group, can enhance accuracy of PCoA aneurysm rupture evaluation. There was the highest incidence of H/D > 1 and H/S ≤ 2 with the largest surface area and SAR-TAWSS, but the lowest incidence of H/D ≤ 1 and H/S > 2 with the smallest surface area and SAR-TAWSS in ruptured PCoA aneurysms. PCoA aneurysms of H/D > 1 and H/S ≤ 2 with surface area > 70 mm2, H/D ≤ 1 and H/S > 2 with neck diameter > 2.3 mm, H/D ≤ 1 and H/S ≤ 2 with aneurysmal height/parent diameter ratio > 1.0, and H/D > 1 and H/S > 2 with aneurysmal angle > 115° need special attention for clinical diagnosis and treatment. The study highlighted the importance of the two-step analysis method for clinical evaluation of PCoA aneurysm rupture. |
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| Keywords: | Intracranial aneurysm DSA Hemodynamics Morphology Risk factor of rupture |
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