Relationship between cerebral aneurysms and variations in cerebral basal arterial network: a morphometric cross-sectional study in Computed Tomography Angiograms from a neurointerventional unit

Abstract

ObjectiveSegments of cerebral basal arterial network (CBAN) dampen the peak pressure in blood flowing through these arteries, thus minimising the chances of development of cerebral aneurysms. The objective of this research was to find the relationship of occurrence of intracranial aneurysms to variations of the components of the CBAN.Design and settingThis is an observational, quantitative and retrospective research, which used cerebral CT angiography (CCTA) images.ParticipantsCerebral CTA of 145 adult patients of both sexes were studied.Main outcome measuresDiameters of segments of CBAN were measured in CCTA images and the relative size of each vessel was calculated to standardise for differences in overall arterial sizes among patients. Relationships among sizes of CBAN components were analysed. Presence of aneurysms in different parts of the CBAN was recorded.ResultsForty-six aneurysms in right internal carotid artery (ICA) and middle cerebral artery (MCA) and 32 aneurysms in left ICA and MCA segments were noted in 42 and 30 patients, respectively. Aneurysms in anterior communicating artery complex and vertebral-basilar arterial segments were seen in 27 and 8 patients, respectively, while they were not detected in parts of posterior cerebral artery (PCA). The significant (p<0.001) inverse relationships between sizes of posterior communicating artery and the first segment of PCA on both sides indicated that blood inputs to the second part of PCA were similar. Difference in means of the index of arterial size variation for people with aneurysms (mean 0.96, SD 0.23) and without aneurysms (mean 0.86, SD 0.22) was significant (p=0.015).ConclusionVariation in segments of CBAN was quantified. The peak pressure dampening mechanism in such arterial segments reduces the chances of development of aneurysms.

Trend of cerebral aneurysms over the past two centuries: need for early screening

“… 18 The most likely internal factor is the severity of the variation on the segments of CBAN that adversely affects the haemodynamics resulting in the formation of aneurysms. 1 19 The condition of the arterial wall should not have changed over the last 260 years and that seems to be less significant than the variation in the components of CBAN. The segmental and communicating arteries play a crucial role in dampening the systolic pressure within the CBAN and reducing the likelihood of aneurysm formation.…”

“…The segmental and communicating arteries play a crucial role in dampening the systolic pressure within the CBAN and reducing the likelihood of aneurysm formation. 1 19 The severity of arterial variation can have negative effects on the blood flow dynamics through the variant segment of the component of the CBAN. 1 19 The incidence of CAs is about 3.3% in the general population and may not be diagnosed, until they get enlarged as the size of the aneurysm <3 mm in diameter can be missed.…”

“… 1 19 The severity of arterial variation can have negative effects on the blood flow dynamics through the variant segment of the component of the CBAN. 1 19 The incidence of CAs is about 3.3% in the general population and may not be diagnosed, until they get enlarged as the size of the aneurysm <3 mm in diameter can be missed. 20 Imaizumi et al found that the prevalence rate of CAs was 4.32% in Japan.…”

Distal Flow Diversion with Anti-Thrombotically Coated and Bare Metal Low-Profile Flow Diverters—A Comparison

“…Furthermore, depending on the symmetry or asymmetry of the AcomA-complex, AcomA-aneurysms have potential inflow from two sources [ 38 , 39 , 40 ]. In case of proximal asymmetry, for example, a type 4 complex according to the classification of Krzyżewski and colleagues, where one dominant A1 segment predominantly supplies the ACA territory with only a minor contribution via the hypoplastic contralateral A1, to which it is connected to by an AcomA, the asymmetry actually facilitates aneurysm occlusion after unilateral hemodynamic intervention.…”

Magnetic soft microfiberbots for robotic embolization

“…Cerebral aneurysms and brain tumors are leading causes of mortality, killing more than 750,000 people annually worldwide ( 1 , 2 ). Before an open surgery is administered, embolization recently has become a prevailing minimally invasive treatment for cerebral aneurysms and brain tumors ( 3 , 4 ).…”