Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Neurosurgery, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands.
J Neurointerv Surg. 2021 Nov;13(11):1049-1052. doi: 10.1136/neurintsurg-2020-017062. Epub 2021 Jan 21.
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.
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.
In a multivariable conditional logistic regression model we showed that smaller diameter size ratio (OR 1.45×10, 95% CI 1.12×10 to 1.88×10) 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.
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.
血流动力学应激取决于周围脉管系统的形态，在动脉瘤形成中起着重要作用。我们的目标是确定与后交通动脉（PCoA）动脉瘤相关的基于图像的特定部位参数。
从 1990 年至 2016 年在布莱根妇女医院和马萨诸塞州综合医院诊断出的 187 例单侧 PCoA 动脉瘤患者的 CT 血管造影或数字减影血管造影中获得三维形态学参数，选择对侧未受影响的 PCoA 作为对照组，以控制遗传和临床危险因素。我们检查了周围母血管和子血管的直径和角度。进行单变量和多变量统计分析以确定统计学意义。仅进行小动脉瘤（≤5mm）的敏感性分析以及 432 个 PCoA 动脉瘤和 197 个无 PCoA 动脉瘤的对照组的不匹配分析。
在多变量条件逻辑回归模型中，我们表明较小的直径比（OR 1.45×10，95%CI 1.12×10 至 1.88×10）和较大的子-子角度（OR 1.04，95%CI 1.02 至 1.07）与 PCoA 动脉瘤存在显著相关，在纠正其他变量后。在小动脉瘤（≤5mm）的亚组分析和不匹配分析中，这些结果的意义和方向得以保留。
较大的子-子角度和较小的直径比与 PCoA 动脉瘤的存在显著相关。这些简单的参数可用于指导高危患者 PCoA 动脉瘤形成的风险评估。
