Abstract
Background: Although pericallosal artery aneurysms (PAAs) are relatively uncommon, accounting for only 1–9% of all intracranial aneurysms (IAs), they exhibit a considerably high propensity to rupture. Nevertheless, our current knowledge of the risk factors for PAA rupture is still very limited. To fill this gap, we investigated rupture risk factors for PAAs based on morphological computer-assisted semiautomated measurement (CASAM) and hemodynamic analysis.Methods: Patients with PAAs were selected from the IA database in our institute and their baseline data were collected. Morphological parameters were measured in all enrolled patients by applying CASAM. Computational fluid dynamics simulation (CFD) was performed to evaluate the hemodynamic difference between ruptured and unruptured PAAs.Results: From June 2017 to June 2020, among 2141 patients with IAs in our institute, 47 had PAAs (2.2%). Thirty-one patients (mean age 57.65 ± 9.97 years) with 32 PAAs (20 unruptured and 12 ruptured) were included in the final analysis. Comparing with unruptured PAAs, ruptured PAAs had significantly higher aspect ratio (AR), mean normalized wall shear stress (NWSS), and mean oscillatory shear index (OSI) values than the unruptured PAAs (all P < 0.05) in univariate analyses. Multivariable analysis showed that a high mean OSI was an independent risk factor for PAA rupture (OR = 6.45, 95% CI 1.37–30.32, P = 0.018).Conclusion: This preliminary study indicates that there are morphological and hemodynamic differences between ruptured and unruptured PAAs. In particular, a high mean OSI is an independent risk factor for PAA rupture. Further research with a larger sample size is warranted in the future.
Highlights
Pericallosal artery aneurysms (PAAs), known as distal anterior cerebral artery (DACA) aneurysms, are defined as intracranial aneurysms (IAs) located on the anterior cerebral artery (ACA) distal to the anterior communicating artery (Dinc et al, 2017; Petr et al, 2017)
According to the results of the quantitative hemodynamic analysis shown in Table 2, the mean oscillatory shear index (OSI) was significantly higher in the ruptured group than in the unruptured group (P = 0.035), and the mean Normalized wall shear stress (NWSS) was significantly lower in the ruptured group than in the unruptured group (P = 0.012)
The results of the multivariate analysis indicated that a high mean OSI was significantly associated with PAA rupture (OR = 6.45, 95% CI 1.37–30.32, P = 0.018)
Summary
Pericallosal artery aneurysms (PAAs), known as distal anterior cerebral artery (DACA) aneurysms, are defined as intracranial aneurysms (IAs) located on the anterior cerebral artery (ACA) distal to the anterior communicating artery (Dinc et al, 2017; Petr et al, 2017). Identifying high-rupture-risk PAAs and subsequently providing selective therapy are of critical importance to these patients. Knowledge of the risk factors of PAAs for rupture remains limited due to the rarity of these lesions. Rupture risk evaluation based on morphological and hemodynamic parameters is critical for the identification of patients with PAAs at high risk for rupture. Pericallosal artery aneurysms (PAAs) are relatively uncommon, accounting for only 1–9% of all intracranial aneurysms (IAs), they exhibit a considerably high propensity to rupture. Our current knowledge of the risk factors for PAA rupture is still very limited. To fill this gap, we investigated rupture risk factors for PAAs based on morphological computer-assisted semiautomated measurement (CASAM) and hemodynamic analysis
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