Geometric variations associated with posterior communicating artery aneurysms.
BACKGROUND
Hemodynamic stress, conditioned by the morphology of the surrounding vasculature, plays an important role in aneurysm formation. Our goal was to identify image-based location-specific parameters that are associated with posterior communicating artery (PCoA) aneurysms.


METHODS
Three-dimensional morphological parameters obtained from CT angiography or digital subtraction angiography from 187 patients with unilateral PCoA aneurysms, diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016, were evaluated. In order to control for genetic and clinical risk factors, we chose the contralateral unaffected PCoA as a control group. We examined diameters and angles of the surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with small aneurysms (≤5 mm) only and an unmatched analysis of 432 PCoA aneurysms and 197 control patients without PCoA aneurysms were also performed.


RESULTS
In a multivariable conditional logistic regression model we showed that smaller diameter size ratio (OR 1.45×10-5, 95% CI 1.12×10-7 to 1.88×10-3) and larger daughter-daughter angle (OR 1.04, 95% CI 1.02 to 1.07) were significantly associated with PCoA aneurysm presence after correcting for other variables. In subgroup analyses of small aneurysms (≤5 mm) and in an unmatched analysis the significance and direction of these results were preserved.


CONCLUSIONS
Larger daughter-daughter angles and smaller diameter size ratio are significantly associated with the presence of PCoA aneurysms. These simple parameters can be utilized to guide the risk assessment for the formation of PCoA aneurysms in high risk patients.
['Zhang|Jian|J|', 'Can|Anil|A|', 'Lai|Pui Man Rosalind|PMR|', 'Mukundan|Srinivasan|S|', 'Castro|Victor M|VM|http://orcid.org/0000-0001-7390-6354', 'Dligach|Dmitriy|D|', 'Finan|Sean|S|', 'Gainer|Vivian|V|', 'Shadick|Nancy|N|', 'Savova|Guergana|G|', 'Murphy|Shawn N|SN|', 'Cai|Tianxi|T|', 'Weiss|Scott T|ST|', 'Du|Rose|R|']
D017542:Aneurysm, Ruptured D015901:Angiography, Digital Subtraction D002533:Cerebral Angiography D002941:Circle of Willis D000072226:Computed Tomography Angiography D005260:Female D006801:Humans D002532:Intracranial Aneurysm
aneurysm hemorrhage subarachnoid