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Analysis of Morphological Parameters to Differentiate Rupture Status in Anterior Communicating Artery Aneurysms
Authors:Ning Lin  Allen Ho  Nareerat Charoenvimolphan  Kai U Frerichs  Arthur L Day  Rose Du
Institution:1. Department of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America.; 2. Harvard Medical School, Boston, Massachusetts, United States of America.; 3. Department of Neurosurgery, University of Texas Medical School at Houston, Houston, Texas, United States of America.; Children''s National Medical Center, Washington, United States of America,
Abstract:In contrast to size, the association of morphological characteristics of intracranial aneurysms with rupture has not been established in a systematic manner. We present an analysis of the morphological variables that are associated with rupture in anterior communicating artery aneurysms to determine site-specific risk variables. One hundred and twenty-four anterior communicating artery aneurysms were treated in a single institution from 2005 to 2010, and CT angiograms (CTAs) or rotational angiography from 79 patients (42 ruptured, 37 unruptured) were analyzed. Vascular imaging was evaluated with 3D Slicer© to generate models of the aneurysms and surrounding vasculature. Morphological parameters were examined using univariate and multivariate analysis and included aneurysm volume, aspect ratio, size ratio, distance to bifurcation, aneurysm angle, vessel angle, flow angle, and parent-daughter angle. Multivariate logistic regression revealed that size ratio, flow angle, and parent-daughter angle were associated with aneurysm rupture after adjustment for age, sex, smoking history, and other clinical risk factors. Simple morphological parameters such as size ratio, flow angle, and parent-daughter angle may thus aid in the evaluation of rupture risk of anterior communicating artery aneurysms.
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