Middle Cerebral Artery Aneurysms

Smith, Robert R.; Zubkov, Yuri N.; Tarassoli, Yahgoub

doi:10.1007/978-1-4613-9532-4_11

Cited by 1 publication

(1 citation statement)

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“…Studies have estimated that MCA aneurysms represent between 18% and 36% of all intracranial aneurysms 13 . MCA aneurysms account for approximately 30% of the aneurysms presenting with acute subarachnoid hemorrhage and for 16% of all giant aneurysms 14 . Because of the high prevalence of MCA aneurysms, detection of local morphological patterns more prone to aneurysm formation could help assist in risk assessment of aneurysm initiation.…”

Section: Introductionmentioning

confidence: 99%

Widening and High Inclination of the Middle Cerebral Artery Bifurcation Are Associated With Presence of Aneurysms

Baharoglu

Lauric

Safain

et al. 2014

Stroke

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Background and Purpose The middle cerebral artery (MCA) bifurcation is a preferred site for aneurysm formation. Wider bifurcations angles have been correlated with increased risk of aneurysm formation. We hypothesized a link between the presence of MCA aneurysms and the angle morphology of the bifurcation. Methods 3D rotational angiography volumes of 146 MCA bifurcations (62 aneurysmal) were evaluated for angle morphology: parent-daughter angles (larger daughter-Φ1, smaller daughter-Φ2), bifurcation angle (Φ1+Φ2), and inclination angle (γ) between the parent vessel axis and the plane determined by daughter vessels axes. Statistics were evaluated using Wilcoxon rank-sum analysis and area under the ROC curve (AUC). Results Aneurysmal bifurcations had wider inclination angle γ (median 57.8° vs. 15.4°; p<0.0001). 75% of aneurysmal MCAs had γ>10°, compared to 25% non-aneurysmal. Φ1, Φ2, but especially Φ1+Φ2 were significantly larger in aneurysmal bifurcations (median 171.3° vs. 98.1°; p<0.0001). 67% of aneurysmal bifurcations had Φ1+Φ2>161°, compared to 0% non-aneurysmal MCAs. An optimal threshold of 140° was established for Φ1+Φ2 (AUC=0.98). 68% of aneurysms originating off the daughter branches. 76% of them originated off the branch with the largest branching angle, specifically if this was the smaller daughter branch. Wider Φ1+Φ2 correlated with aneurysm neck width, but not dome size. Conclusion MCA bifurcations harboring aneurysms have significantly larger branching angles, and more often originate off of the branch with the largest angle. Wider inclination angle is strongly correlated with aneurysm presence, a novel finding. The results point to altered WSS regulation as a possible factor in aneurysm development and progression.

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Section: Introductionmentioning

confidence: 99%