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17-04-2024 | Aneurysm | Original Article

Investigation of the morphometric characteristics of internal carotid artery between sexes and in patients with intracranial aneurysms

Authors: Yigit Cevik, Hasan Bilen Onan, Huseyin Erdem, Emine Dondu Kizilkanat, Sevinc Puren Yucel, Ozkan Oguz

Published in: Surgical and Radiologic Anatomy

Abstract

Purpose

The purpose of this study is to investigate the morphometric properties of the internal carotid artery (ICA) by measuring the diameters and angles of its segments and exploring variations related to sex and the presence of aneurysms.

Methods

Digital subtraction angiography (DSA) images were utilized from 130 aneurysm patients and 75 non-aneurysm individuals to create 3D ICA models using 3D Slicer software. Segment diameters were measured via Autodesk Meshmixer 3.5.474 and angles were evaluated using ImageJ software.

Results

In total, DSA images of 130 aneurysm patients and 75 individuals with normally reported carotid systems were evaluated. It was found that the intracranial aneurysms (IAs) were predominantly formed on the anterior cerebral artery (ACA) in males (%43), whereas in females IAs were frequently localized in the C6 segment (31.7%) and middle cerebral artery (MCA) (30.2%). In the control group, the evaluation of gender differences in segment diameters and angles revealed that males had significantly larger C4 and C5 segment diameters (4.62 vs. 4.32 mm and 4.41 vs. 4.09 mm, respectively) and a greater C6 angle (146.9° vs. 139.7°) compared to females. Comparisons between patients with an aneurysm at the anterior cerebral artery (ACA) and the control group revealed that the ACA group had wider diameters in the C1 (4.88 vs. 4.53 mm), C3 (4.65 vs. 4.4 mm), C5 (4.51 vs. 4.25 mm), and ACA (2.36 vs. 2.06 mm) segments. Additionally, the ACA group had wider angles in the ACA (104.1° vs. 94.1°) and C6 segments (147.7° vs. 143.3°), whereas the control group exhibited wider angles in the middle cerebral artery (MCA) segment (141.5° vs. 135.5°) compared to the ACA aneurysm group. Patients with anterior cerebral artery (ACA) aneurysms exhibited larger diameters in C1, C3, C5, C6, and ACA segments compared to the control group. Additionally, while the control group had larger MCA angle, patients with ACA aneurysms had larger angles in C6 segment and ACA.

Conclusion

Our results demonstrated that formation of aneurysms is affected by anatomical configuration of the ICA as well as sex characteristics, particularly regarding the ACA and MCA bifurcation angles, which showed associations with aneurysms in the respective branches.

Baharoglu MI, Schirmer CM, Hoit DA, Gao BL, Malek AM (2010) Aneurysm inflow-angle as a discriminant for rupture in sidewall cerebral aneurysms: morphometric and computational fluid dynamic analysis. Stroke 41(7):1423–1430. https://doi.org/10.1161/strokeaha.109.570770CrossRefPubMed

Bouthillier A, van Loveren HR, Keller JT (1996) Segments of the internal carotid artery: a new classification. Neurosurgery 38(3):425–432; discussion 432–423. https://doi.org/10.1097/00006123-199603000-00001

Caranci F, Briganti F, Cirillo L, Leonardi M, Muto M (2013) Epidemiology and genetics of intracranial aneurysms. Eur J Radiol 82(10):1598–1605. https://doi.org/10.1016/j.ejrad.2012.12.026CrossRefPubMed

Castro MA, Putman CM, Cebral JR (2006) Computational fluid dynamics modeling of intracranial aneurysms: effects of parent artery segmentation on intra-aneurysmal hemodynamics. AJNR Am J Neuroradiol 27(8):1703–1709PubMedPubMedCentral

Cebral JR, Castro MA, Burgess JE, Pergolizzi RS, Sheridan MJ, Putman CM (2005) Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models. AJNR Am J Neuroradiol 26(10):2550–2559PubMedPubMedCentral

Chistiakov DA, Orekhov AN, Bobryshev YV (2017) Effects of shear stress on endothelial cells: go with the flow. Acta Physiol (Oxf) 219(2):382–408. https://doi.org/10.1111/apha.12725CrossRefPubMed

Detmer FJ, Chung BJ, Jimenez C, Hamzei-Sichani F, Kallmes D, Putman C, Cebral JR (2019) Associations of hemodynamics, morphology, and patient characteristics with aneurysm rupture stratified by aneurysm location. Neuroradiology 61(3):275–284. https://doi.org/10.1007/s00234-018-2135-9CrossRefPubMed

Duan Z, Li Y, Guan S, Ma C, Han Y, Ren X, Wei L, Li W, Lou J, Yang Z (2018) Morphological parameters and anatomical locations associated with rupture status of small intracranial aneurysms. Sci Rep 8(1):6440. https://doi.org/10.1038/s41598-018-24732-1CrossRefPubMedPubMedCentral

Etminan N, Rinkel GJ (2015) Cerebral aneurysms: Cerebral aneurysm guidelines—more guidance needed. Nat Rev Neurol 11(9):490–491. https://doi.org/10.1038/nrneurol.2015.146CrossRefPubMed

10.

Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin J-C, Pujol S, Bauer C, Jennings D, Fennessy F, Sonka M (2012) 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging 30(9):1323–1341

11.

Hoi Y, Meng H, Woodward SH, Bendok BR, Hanel RA, Guterman LR, Hopkins LN (2004) Effects of arterial geometry on aneurysm growth: three-dimensional computational fluid dynamics study. J Neurosurg 101(4):676–681. https://doi.org/10.3171/jns.2004.101.4.0676CrossRefPubMed

12.

Humphrey JD, Taylor CA (2008) Intracranial and abdominal aortic aneurysms: similarities, differences, and need for a new class of computational models. Annu Rev Biomed Eng 10:221–246. https://doi.org/10.1146/annurev.bioeng.10.061807.160439

13.

Kongable GL, Lanzino G, Germanson TP, Truskowski LL, Alves WM, Torner JC, Kassell NF (1996) Gender-related differences in aneurysmal subarachnoid hemorrhage. J Neurosurg 84(1):43–48. https://doi.org/10.3171/jns.1996.84.1.0043CrossRefPubMed

14.

Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15(2):155–163. https://doi.org/10.1016/j.jcm.2016.02.012CrossRefPubMedPubMedCentral

15.

Krejza J, Arkuszewski M, Kasner SE, Weigele J, Ustymowicz A, Hurst RW, Cucchiara BL, Messe SR (2006) Carotid artery diameter in men and women and the relation to body and neck size. Stroke 37(4):1103–1105. https://doi.org/10.1161/01.STR.0000206440.48756.f7CrossRefPubMed

16.

Krzyżewski RM, Kliś KM, Kucala R, Polak J, Kwinta BM, Starowicz-Filip A, Stachura K, Piszczek K, Moskała M, Tomaszewski KA (2018) Intracranial aneurysm distribution and characteristics according to gender. Br J Neurosurg 32(5):541–543. https://doi.org/10.1080/02688697.2018.1518514CrossRefPubMed

17.

Lindekleiv HM, Valen-Sendstad K, Morgan MK, Mardal KA, Faulder K, Magnus JH, Waterloo K, Romner B, Ingebrigtsen T (2010) Sex differences in intracranial arterial bifurcations. Gend Med 7(2):149–155. https://doi.org/10.1016/j.genm.2010.03.003CrossRefPubMed

18.

Longstreth WT, Nelson LM, Koepsell TD, van Belle G (1994) Subarachnoid hemorrhage and hormonal factors in women. A population-based case-control study. Ann Intern Med 121(3):168–173. https://doi.org/10.7326/0003-4819-121-3-199408010-00002

19.

Mahrous SA, Sidik NAC, Saqr KM (2021) Numerical study on the energy cascade of pulsatile Newtonian and power-law flow models in an ICA bifurcation. PLoS ONE 16(1):e0245775. https://doi.org/10.1371/journal.pone.0245775CrossRefPubMedPubMedCentral

20.

Meng H, Tutino VM, Xiang J, Siddiqui A (2014) High WSS or low WSS? Complex interactions of hemodynamics with intracranial aneurysm initiation, growth, and rupture: toward a unifying hypothesis. AJNR Am J Neuroradiol 35(7):1254–1262. https://doi.org/10.3174/ajnr.A3558CrossRefPubMedPubMedCentral

21.

Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK, Rinkel GJ (2009) Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol 8(7):635–642. https://doi.org/10.1016/s1474-4422(09)70126-7CrossRefPubMed

22.

Nixon AM, Gunel M, Sumpio BE (2010) The critical role of hemodynamics in the development of cerebral vascular disease. J Neurosurg 112(6):1240–1253. https://doi.org/10.3171/2009.10.Jns09759CrossRefPubMed

23.

Piccinelli M, Bacigaluppi S, Boccardi E, Ene-Iordache B, Remuzzi A, Veneziani A, Antiga L (2011) Geometry of the internal carotid artery and recurrent patterns in location, orientation, and rupture status of lateral aneurysms: an image-based computational study. Neurosurgery 68(5):1270–1285; discussion 1285. https://doi.org/10.1227/NEU.0b013e31820b5242

24.

Rasband W (2007) ImageJ, US national institutes of health. http://rsb.info.nih.gov/ij/(1997–2007)

25.

Roi DP, Mueller JD, Lobotesis K, McCague C, Memarian S, Khan F, Mankad K (2019) Intracranial aneurysms: looking beyond size in neuroimaging: the role of anatomical factors and haemodynamics. Quant Imaging Med Surg 9(4):537–545. https://doi.org/10.21037/qims.2019.03.19

26.

Schulz UG, Rothwell PM (2001) Sex differences in carotid bifurcation anatomy and the distribution of atherosclerotic plaque. Stroke 32(7):1525–1531. https://doi.org/10.1161/01.str.32.7.1525CrossRefPubMed

27.

Zhang X-J, Li C-H, Hao W-L, Zhang D-H, Ren C-F, Gao B-L (2018) Enlarged anterior cerebral artery bifurcation angles may induce abnormally enhanced hemodynamic stresses to initiate aneurysms. World Neurosurg 120:e783–e791. https://doi.org/10.1016/j.wneu.2018.08.167

Title: Investigation of the morphometric characteristics of internal carotid artery between sexes and in patients with intracranial aneurysms
Authors: Yigit Cevik
Hasan Bilen Onan
Huseyin Erdem
Emine Dondu Kizilkanat
Sevinc Puren Yucel
Ozkan Oguz
Publication date: 17-04-2024
Publisher: Springer Paris
Keywords: Aneurysm
Aneurysm
Intracranial Aneurysm
Published in: Surgical and Radiologic Anatomy
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-024-03351-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Investigation of the morphometric characteristics of internal carotid artery between sexes and in patients with intracranial aneurysms

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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