Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Clin Neuroradiol. 2024 Jun;34(2):485-494. doi: 10.1007/s00062-024-01394-3. Epub 2024 Feb 28.
Tortuosity of the internal carotid artery (ICA) is associated with intracranial aneurysms (IAs). The siphon is the most curved segment of the ICA, but its morphology has controversial effects on IAs. This study aimed to explore the morphometric features of the siphon and the potential hemodynamic mechanisms that may affect C7 aneurysm formation.
In this study 32 patients with C7 aneurysms diagnosed at Xiangya Hospital between 2019 and 2021 and 32 control subjects were enrolled after propensity score matching. Computed tomography angiography (CTA) images were acquired to measure morphologic features, and then, by combining clinical data, simplified carotid siphon models were constructed, and computational fluid dynamics (CFD) analysis was performed.
The presence of C7 aneurysms was associated with the height of the C4-C6 curved arteries (odds ratio [OR] 0.028, 95% confidence interval [CI] 0.003-0.201; P < 0.001). The heights of the C4-C6 curved arteries in the aneurysm group were significantly shorter than those in the control group. The CFD analysis revealed that shorter C4-C6 bends led to greater blood velocity and pressure in the C7 segment arteries.
A shorter C4-C6 bend was associated with distal C7 aneurysm formation, and an elaborate hemodynamic mechanism may underlie this association.
颈内动脉（ICA）迂曲与颅内动脉瘤（IAs）有关。虹吸段是 ICA 最弯曲的部分，但它的形态对 IAs 有争议的影响。本研究旨在探讨虹吸段的形态特征及可能影响 C7 动脉瘤形成的潜在血流动力学机制。
本研究纳入了 2019 年至 2021 年在湘雅医院诊断为 C7 动脉瘤的 32 例患者和 32 名对照患者，通过倾向评分匹配进行选择。采集计算机断层血管造影（CTA）图像以测量形态特征，然后结合临床数据构建简化的颈动脉虹吸模型，并进行计算流体动力学（CFD）分析。
C7 动脉瘤的存在与 C4-C6 弯曲段的高度有关（比值比 [OR] 0.028，95%置信区间 [CI] 0.003-0.201；P<0.001）。动脉瘤组 C4-C6 弯曲段的高度明显短于对照组。CFD 分析表明，较短的 C4-C6 弯曲导致 C7 段动脉的血流速度和压力增加。
C4-C6 弯曲较短与远端 C7 动脉瘤形成有关，其潜在的血流动力学机制可能与此有关。
