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Acta Neurochirurgica
Published in: Acta Neurochirurgica 9/2017

01-09-2017 | Original Article - Vascular

CTA analysis and assessment of morphological factors related to rupture in 413 posterior communicating artery aneurysms

Authors: Justiina Huhtakangas, Martin Lehecka, Hanna Lehto, Behnam Rezai Jahromi, Mika Niemelä, Riku Kivisaari

Published in: Acta Neurochirurgica | Issue 9/2017

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Abstract

Posterior communicating artery (PcomA) aneurysms are frequently encountered, but there are few publications on their morphology. A growing number of aneurysms are incidental findings, which makes evaluation of rupture risk important. Our goal was to identify morphological features and anatomical variants associated with PComA aneurysms and to assess parameters related to rupture. We studied CT angiographies of 391 consecutive patients treated between 2000 and 2014 at a single institution. We determined clinically important morphological parameters and performed univariate and multivariate analysis. There were a total of 413 PComA aneurysms: 258 (62%) were ruptured and 155 (38%) unruptured. Ruptured PComA aneurysms had the potential to cause severe bleeding with IVH and/or temporal ICH (n = 170, 66% of ruptured). The main types of PComA origin were classified as follows: (1) separate (32%), (2) side by side (21%) and (3) a joint neck with the aneurysm (6%). After the multivariate logistic regression, the morphological parameters related to PComA aneurysm rupture were an irregular aneurysm dome, neck diameter, and aspect ratio >1.5. The most marked morphological features of the PComA aneurysms were: saccular nature (99%), infero-posterior dome orientation (42%), infrequency of large or giant aneurysms (4%), narrow neck compared to the aneurysm size, PComA originating directly from the aneurysm neck or the dome (28%), and fetal or dominant PComA on the side of the aneurysm (35%). There were location-related parameters that were more strongly associated with PComA aneurysm rupture than aneurysm size: an irregular aneurysm dome, larger diameter of the aneurysm neck and aspect ratio >1.5.
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Metadata
Title
CTA analysis and assessment of morphological factors related to rupture in 413 posterior communicating artery aneurysms
Authors
Justiina Huhtakangas
Martin Lehecka
Hanna Lehto
Behnam Rezai Jahromi
Mika Niemelä
Riku Kivisaari
Publication date
01-09-2017
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 9/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-017-3263-4

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