Abstract
Background: This study was conducted to explore the risk factors of anterior circulation intracranial aneurysm rupture based on extracranial carotid artery (ECA) tortuosity.Methods: This retrospective study, conducted from January 1, 2017, to March 1, 2021, collected and reviewed the clinical and imaging data of 308 patients with anterior circulation intracranial aneurysm [133 (43.2%) patients in the ruptured aneurysm group; 175 (56.8%) patients in the unruptured aneurysm group]. Computed tomography angiography (CTA) of the head and neck was used to determine the ECA tortuosity (normal, simple tortuosity, kink, coil) and the morphologic parameters of the aneurysms. The relationship of aneurysm rupture to ECA tortuosity and the morphologic parameters were analyzed.Results: After univariate analysis, kink, angle of flow inflow (FA), aspect ratio (AR), aneurysm length (L), the distance from the tortuosity to the aneurysm (distance), and size ratio (SR) were significantly correlated with anterior circulation intracranial aneurysm rupture (p < 0.05). Spearman correlation analysis showed that ECA tortuosity was correlated with FA and SR (p < 0.05). Multiple logistic analyses showed that FA [odds ratio (OR), 1.013; 95% CI, 1.002–1.025], SR (OR, 1.521; 95% CI, 1.054–2.195), and kink (OR, 1.823; 95% CI, 1.074–3.096) were independently associated with aneurysm rupture.Conclusion: Study results suggest that FA, SR, and ECA kink were independent risk factors associated with anterior circulation intracranial aneurysm rupture.
Highlights
Studies in the literature have reported that intracranial aneurysm prevalence rate can be as high as 3% [1, 2]
Multiple logistic analyses showed that FA [odds ratio (OR), 1.013; 95% CI, 1.002–1.025], size ratio (SR) (OR, 1.521; 95% CI, 1.054–2.195), and kink (OR, 1.823; 95% CI, 1.074–3.096) were independently associated with aneurysm rupture
Study results suggest that FA, SR, and Extracranial carotid artery (ECA) kink were independent risk factors associated with anterior circulation intracranial aneurysm rupture
Summary
Studies in the literature have reported that intracranial aneurysm prevalence rate can be as high as 3% [1, 2]. Research on the correlation between ECA tortuosity and intracranial aneurysm was carried out relatively late. It was not until 2017 that Labeyrie et al [10] conducted a correlation study on ECA tortuosity and the occurrence of intracranial aneurysms. The main risk factors for intracranial aneurysm progression and rupture are morphologic parameters and hemodynamics, and the two influence each other [13,14,15]. We studied the ECA tortuosity and aneurysm morphologic parameters, and we further analyzed what factors were associated with anterior circulation intracranial aneurysm rupture. This study was conducted to explore the risk factors of anterior circulation intracranial aneurysm rupture based on extracranial carotid artery (ECA) tortuosity
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