Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, No. 5 Jingyuan Road, Beijing, 100043, China.
Department of Neurosurgery, University Hospital of Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Neurosurg Rev. 2020 Apr;43(2):589-595. doi: 10.1007/s10143-019-01080-w. Epub 2019 Jan 31.
The aim of this study is to characterize demographic and morphologic characteristics of aneurysms located in the anterior communicating artery (ACoA) and to investigate possible associations between these characteristics and aneurysm rupture. We investigated 112 consecutive patients (72 ruptured and 40 unruptured) with ACoA aneurysms from a single-center database. The effects of demographic and morphologic characteristics on the risk of rupture in ACoA aneurysms were tested using univariate and multivariate logistic regression analyses, respectively. We found that larger size, greater size ratio, larger flow angle, irregular shape, and smoking of the patient were associated with the rupture of ACoA aneurysms based on univariate analysis. Size ratio (OR = 3.890, P = 0.003), irregular shape (OR = 1.068, P = 0.001), flow angle (OR = 1.054, P = 0.001), and current smoking (OR = 4.435, P = 0.009) were the strongest factors related to ruptured ACoA aneurysms based on multivariate logistic regression analysis. The areas under the curves for the flow angle and size ratio were 0.742 (95% CI 0.646-0.838; P = 0.001) and 0.736 (95% CI 0.621-0.796; P = 0.001), respectively. The strongest risk factors for rupture include size ratio, irregular shape, flow angle, and current smoking. These features should be taken into consideration to aid in the prediction of the rupture risk of ACoA aneurysms.
本研究旨在描述前交通动脉(ACoA)动脉瘤的人口统计学和形态学特征,并探讨这些特征与动脉瘤破裂之间的可能关联。我们从单中心数据库中调查了 112 例连续的 ACoA 动脉瘤患者(72 例破裂和 40 例未破裂)。使用单变量和多变量逻辑回归分析分别测试人口统计学和形态学特征对 ACoA 动脉瘤破裂风险的影响。我们发现,根据单变量分析,动脉瘤的更大尺寸、更大的尺寸比、更大的血流角度、不规则形状和患者吸烟与 ACoA 动脉瘤的破裂有关。尺寸比(OR=3.890,P=0.003)、不规则形状(OR=1.068,P=0.001)、血流角度(OR=1.054,P=0.001)和当前吸烟(OR=4.435,P=0.009)是基于多变量逻辑回归分析与破裂的 ACoA 动脉瘤相关的最强因素。血流角度和尺寸比的曲线下面积分别为 0.742(95%置信区间 0.646-0.838;P=0.001)和 0.736(95%置信区间 0.621-0.796;P=0.001)。破裂的最强危险因素包括尺寸比、不规则形状、血流角度和当前吸烟。这些特征应考虑在内,以帮助预测 ACoA 动脉瘤的破裂风险。