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European Radiology

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Open Access 01-11-2019 | Aneurysm | Vascular-Interventional

Increased tortuosity of ACA might be associated with increased risk of ACoA aneurysm development and less aneurysm dome size: a computer-aided analysis

Authors: Roger M. Krzyżewski, Kornelia M. Kliś, Borys M. Kwinta, Małgorzata Gackowska, Jerzy Gąsowski

Published in: European Radiology | Issue 11/2019

Abstract

Objectives

We decided to perform computer-aided analysis of the anterior cerebral artery (ACA) to check for a potential correlation with anterior communicating artery (ACoA) aneurysm presence and growth.

Methods

We retrospectively analyzed the ACA anatomy of 121 patients with ACoA aneurysms along with 121 age, risk factors, and vessel side-matched control patients without an ACoA aneurysm. We obtained their medical history and digital subtraction angiography (DSA) data from their medical records. For each patient’s DSA, we extracted curve representing the course of their ACA and calculated its relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD), and inflection count metrics (ICM).

Results

Patients with ACoA aneurysm had significantly higher RL (0.64 ± 0.23 vs. 0.56 ± 0.22; p < 0.01), SOAM (0.27 ± 0.19 vs. 0.18 ± 0.15; p < 0.01), PAD (0.12 ± 0.13 vs. 0.09 ± 0.11; p = 0.02), and TI (0.57 ± 0.14 vs. 0.44 ± 0.15; p < 0.01). In multivariate logistic regression analysis, after adjustment for possible confounders, SOAM (OR, 1.34; 95% CI, 1.12–1.63; p < 0.01) and TI (OR, 1.84; 95% CI, 1.47–2.35; p < 0.01) remained independently associated with higher risk of ACoA aneurysm. Additionally, we found significant negative correlations between TI and aneurysm dome size (R = − 0.194; p = 0.047).

Conclusions

Increased tortuosity of ACA might increase the risk of ACoA aneurysm development and decrease the risk of aneurysm growth.

Key Points

• Anterior cerebral artery’s sum of angle metrics is associated with hypertension as well as with history of ischemic stroke and myocardial infarction.

• Increased tortuosity of anterior cerebral artery might be associated with anterior communicating artery aneurysm development.

• Tortuosity of anterior cerebral artery is negatively correlated with anterior communicating artery aneurysm dome size.

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Krzyżewski RM, Kliś KM, Kwinta BM et al (2018) Analysis of anterior cerebral artery tortuosity: association with anterior communicating artery aneurysm rupture. World Neurosurg. https://doi.org/10.1016/j.wneu.2018.10.086

Title: Increased tortuosity of ACA might be associated with increased risk of ACoA aneurysm development and less aneurysm dome size: a computer-aided analysis
Authors: Roger M. Krzyżewski
Kornelia M. Kliś
Borys M. Kwinta
Małgorzata Gackowska
Jerzy Gąsowski
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keywords: Aneurysm
Aneurysm
Published in: European Radiology / Issue 11/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06146-3

At a glance: The STEP trials

Springer Medicine

Increased tortuosity of ACA might be associated with increased risk of ACoA aneurysm development and less aneurysm dome size: a computer-aided analysis

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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