Morphological and Hemodynamic Analysis of Mirror Posterior Communicating Artery Aneurysms

Abstract

Background and PurposeHemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology.Materials and Methods3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs). Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture.ResultsThe normalized mean wall shear stress (WSS) of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012). The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018). The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012). By contrast, parameters that had no significant differences between the two groups were OSI (P = .674), aneurysm size (P = .327), size ratio (P = .779), vessel angle (P = 1.000) and aneurysm inclination angle (P = 1.000).ConclusionsPcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.

Morphological characteristics associated with the rupture risk of mirror posterior communicating artery aneurysms

“…Jiang et al 13 showed that the threshold value of AR was 1.2. In the current study, our data showed that a value for AR ≥0.98 was associated with PComAA rupture, which was smaller than most previous studies but very close to the value of AR reported by Xu et al 12, whose data showed that the value of AR was 1. Hence it may infer that compared with that of other locations, a smaller threshold value of AR may indicate that PComAAs are more prone to rupture.…”

Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case–control study

“…Xiang et al 10 compared the hemodynamics and morphology of 38 ruptured aneurysms and 81 unruptured aneurysms and found that lower WSS was a risk factor for aneurysm rupture; indeed, as the WSS increased, the risk of aneurysm rupture decreased. In a previous hemodynamic study on mirror PcomA aneurysms, we also showed that, compared with unruptured aneurysms, ruptured aneurysms have a lower WSS and a larger low WSS area 4. In another study11 we observed that unruptured PcomA aneurysms with oculomotor nerve palsy have lower WSS than ruptured aneurysms.…”

Analysis of Morphologic and Hemodynamic Parameters for Unruptured Posterior Communicating Artery Aneurysms with Oculomotor Nerve Palsy

“…23 We found that lower WSS, higher LSA, and higher OSI contribute to aneurysm rupture. However, our results in this study only demonstrated that WSS of the aneurysm wall was significantly different between the 2 groups, instead of LSA or OSI hemodynamically.…”