Three-Dimensional Morphometric Analysis of Anterior Cerebral Circulation Aneurysms.
Giancarlo Saal-ZapataIsaac Josh AbecassisRosa Cervantes-MedinaRodolfo Rodríguez-VarelaPublished in: The International journal of angiology : official publication of the International College of Angiology, Inc (2023)
This article assesses the association between anterior circulation morphometry and the presence of intracranial aneurysm using three-dimensional rotational angiography (3DRA). A retrospective analysis at a Peruvian academic medical center between December 2018 and February 2020 identified 206 patients with unruptured intracranial aneurysms and matched controls who underwent 3DRA. Angiographic images were obtained per standard of care, and measurements of the vasculature were performed using 3DRA vascular automated software. A total of 163 aneurysms and 43 control angiograms were evaluated. Women represented 82.5% of the cases and the mean age was 55.9 years (standard deviation ± 14.2). In multivariate analysis, five specific features were found to be statistically significant predictors for presence of an anterior circulation aneurysm: female sex (odds ratio [OR] = 2.71; p = 0.048), C-shape of the middle cerebral artery (MCA) (OR = 2.73; p = 0.018), distal internal carotid artery (ICA) diameter (OR = 3.42; p = 0.012), ICA bifurcation angle (OR = 1.02; p = 0.036), and length of the carotid siphon (OR = 1.08; p = 0.047). Features detected on 3DRA suggest morphological characteristics of the ICA and MCA may be predictive for intracranial aneurysm. Our findings build from prior reports by demonstrating five specific patient and imaging features associated with anterior circulation aneurysms. While 3DRA is the standard of care in many settings, medical centers with resource limitations may not have access to this technique. The demographic and morphological features identified in our study may have correlates that if detected on contrast computed tomography or magnetic resonance imaging studies, may be used to help screen for a higher level of care in select patients.
Keyphrases
- middle cerebral artery
- internal carotid artery
- computed tomography
- healthcare
- magnetic resonance imaging
- palliative care
- coronary artery
- quality improvement
- optical coherence tomography
- high resolution
- optic nerve
- deep learning
- end stage renal disease
- ejection fraction
- contrast enhanced
- high throughput
- affordable care act
- newly diagnosed
- pain management
- positron emission tomography
- polycystic ovary syndrome
- minimally invasive
- metabolic syndrome
- abdominal aortic aneurysm
- machine learning
- pregnant women
- peritoneal dialysis
- adipose tissue
- insulin resistance
- blood brain barrier
- brain injury
- cerebral ischemia
- skeletal muscle
- patient reported
- fluorescence imaging