Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms

Nan Lv; Chi Wang; Christof Karmonik; Yibin Fang; Jinyu Xu; Ying Yu; Wei Cao; Jianmin Liu; Qinghai Huang

doi:10.1371/journal.pone.0149906

Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms

PLoS One. 2016 Feb 24;11(2):e0149906. doi: 10.1371/journal.pone.0149906. eCollection 2016.

Authors

Nan Lv¹, Chi Wang¹, Christof Karmonik², Yibin Fang¹, Jinyu Xu¹, Ying Yu¹, Wei Cao¹, Jianmin Liu¹, Qinghai Huang¹

Affiliations

¹ Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
² Cerebrovascular Center, Department of Neurosurgery, Houston Methodist, Houston, Texas, United States of America.

Abstract

Background and purpose: The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA) aneurysms.

Materials and methods: In 129 PCoA aneurysms (85 ruptured, 44 unruptured), clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms.

Results: While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR), size ratio (SR), dome-to-neck ratio (DN), inflow angle (IA), normalized wall shear stress (NWSS) and percentage of low wall shear stress area (LSA) were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p < 0.001) and LSA (OR = 1.393, p = 0.041).

Conclusions: Hemodynamics and morphology were related to rupture status of intracranial aneurysms. Higher IA and LSA were identified as discriminators for rupture status of PCoA aneurysms.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aneurysm, Ruptured* / pathology
Aneurysm, Ruptured* / physiopathology
Female
Hemodynamics*
Humans
Intracranial Aneurysm* / pathology
Intracranial Aneurysm* / physiopathology
Male
Middle Aged
Models, Cardiovascular*

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 81301004) received by YF and by (No. 81571118) received by QH, the National Science-technology Support Plan Projects (No. 2011BAI08B06) received by JL, the Key Project of Shanghai Science and Technology Committee (No.13411950300) received by JL, and the Key Project of Shanghai Municipal Health Bureau (No.2013ZYJB007) received by JL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.