Identification of a dichotomy in morphological predictors of rupture status between sidewall- and bifurcation-type intracranial aneurysms

Abstract

Retrospective morphological and hemodynamic analysis point to a dichotomy between sidewall and bifurcation aneurysms with respect to performance of shape and size parameters in identifying rupture status, suggesting the need for aneurysm type-based analyses in future studies. The current most commonly used clinical risk assessment metric, D(max), was found to be of no value in differentiating between ruptured and unruptured bifurcation aneurysms.

Mind the Gap: Impact of Computational Fluid Dynamics Solution Strategy on Prediction of Intracranial Aneurysm Hemodynamics and Rupture Status Indicators

“…5 This scenario is particularly true for bifurcation aneurysms, where we have clearly demonstrated a strong impact of solution strategy on the predicted hemodynamics, as opposed to sidewall aneurysms, for which NR simulations were largely adequate. Baharoglu et al 27 recently reported a dichotomy between sidewall and bifurcation aneurysms (ie, morphologic discriminants were accurate for sidewall aneurysms, but not for bifurcation aneurysms). This finding suggests that there may be a different mechanistic link to rupture in bifurcation aneurysms.…”

Morphometric Features of Ruptured and Unruptured Aneurysms in Surgically Treated Patients with Multiple Intracranial Aneurysms

“…Irregular shape is found more often in ruptured aneurysms [11][12][13]. Previous studies on aneurysm inclination angle showed different results from insignificant to strongly significant odds ratios [7,[14][15][16].…”

Geometric Parameter Analysis of Ruptured and Unruptured Aneurysms in Patients with Symmetric Bilateral Intracranial Aneurysms: A Multicenter CT Angiography Study

“…10,14,15 However, various authors have shown that a large proportion of ruptured aneurysms are, in fact, Ͻ7 mm. [16][17][18] Our study indicates that the mean size of ruptured aneurysms is 5.29 mm (range, 2.0 -11.3 mm). More often than not, the ruptured aneurysm is not the largest aneurysm.…”

“…5,13,16,[31][32][33] The conflicting results may be ascribed to limited follow-up data and differences in imaging techniques and measurement methodology. The area ratio takes into account the aneurysm itself (maximal perpendicular height and aneurysm width) and the local vessel (Dv and neck width).…”