Extracranial Aneurysms Research Articles

Nonlinear biomechanical behaviour of extracranial carotid artery aneurysms in the framework of Windkessel effect via FSI technique

Extracranial carotid artery aneurysms (ECCA) lead to rupture and neurologic symptoms from embolisation, with potentially fatal outcomes. Investigating the biomechanical behaviour of EECA with blood flow dynamics is crucial for identifying regions more susceptible to rupture. A coupled three-dimensional (3D) Windkessel-framework and hyperelastic fluid-structure interaction (FSI) analysis of ECCAs with patient-specific geometries, was developed in this paper with a particular focus on hemodynamic parameters and the arterial wall's biomechanical response. The blood flow has been modelled as non-Newtonian, pulsatile, and turbulent. The biomechanical characteristics of the aneurysm and artery are characterised employing a 5-parameter Mooney-Rivlin hyperelasticity model. The Windkessel effect is also considered to efficiently simulate pressure profile of the outlets and to capture the dynamic changes over the cardiac cycle. The study found the aneurysm carotid artery exhibited the high levels of pressure, wall shear stress (WSS), oscillatory shear index (OSI), and relative residence time (RRT) compared to the healthy one. The deformation of the arterial wall and the corresponding von Mises (VM) stress were found significantly increased in aneurysm cases, in comparison to that of no aneurysm cases, which strongly correlated with the hemodynamic characteristics of the blood flow and the geometric features of the aneurysms. This escalation would intensify the risk of aneurysm wall rupture. These findings have critical implications for enhancing treatment strategies for patients with extracranial aneurysms.

Treatment of a Rare Case of Giant Vertebral Extracranial Aneurysm

Extracranial vertebral artery (VA) aneurysms are extremely rare and are usually associated with trauma or dissection. Primary extracranial VA aneurysms are far less common. They may be of mycotic origin or associated with systemic diseases such as neurofibromatosis. The presentation and natural history remains idiopathic, and operative management can be often difficult. Angiography remains the gold standard in diagnosis and characterisation of these lesions. We hereby present a case of a primary aneurysm of the extracranial portion of the vertebral artery and its surgical management, which implied an initial endosvacular approach followed by a two-step surgery in order to resect the aneurysm and stabilise the spine.

Single Center Experience in Surgical Treatment of Extracranial Supra-Aortic Aneurysms

Objective To evaluate the effect of surgical treatment on extracranial supra-aortic aneurysms and summarize the experience. Methods The clinical data of 10 patients undergoing surgical treatment of extracranial supra-aortic aneurysms from May 2019 to November 2023 in the Department of Vascular Surgery of Beijing Tiantan Hospital affiliated to Capital Medical University were collected.The 10 patients included 5 patients with internal carotid artery aneurysm,2 patients with subclavian artery aneurysm,2 patients with vertebral artery aneurysm,and 1 patient with internal carotid artery aneurysm combined with ipsilateral subclavian artery aneurysm.The surgical indications,surgical regimens,clinical efficacy,and complications were retrospectively analyzed. Results All the 10 patients underwent surgery successfully,with the surgery duration range of 60-420 min and the median surgery duration of 180.0 (121.5,307.5) min.Intraoperative bleeding volume varied within 30-400 mL,with a median of 90 (50,125) mL.The time of carotid artery blocking and vertebral artery blocking varied within the ranges of 10-20 min and 20-30 min,with the medians of 15.0 (11.5,16.3) min and 25.0 (15.0,22.5) min,respectively.No cardiac accident,cerebral infarction,or cerebral hemorrhage occurred during the perioperative period.The 10 patients were followed up for 3-58 months,with the median follow-up time of 8.5 (5.3,17.0) months.One patient with subclavian artery aneurysm developed artificial vessel occlusion 20 months after surgery.One patient with internal carotid artery aneurysm developed distal carotid artery stenosis 6 months after surgery. Conclusion Surgical treatment should be actively adopted for extracranial supra-aortic aneurysms,and individualized surgical regimens should be designed according to patient conditions.

Endovascular treatment of large posttraumatic false aneurysm of the S2 segment of the subclavian artery: clinical case and literature review

Introduction. Pseudoaneurysms of the subclavian artery are a rare pathology and most frequently occur due to trauma. According to the current literature, subclavian artery aneurysms account for 1 % of all peripheral artery aneurysms. This pathology, although rare, may be accompanied by the risk of rupture, thrombosis, or distal embolism of the arterial lumen. Objective. To demonstrate a clinical case of a patient with successful treatment of subclavian artery pseudoaneurysm by means of modern minimally invasive endovascular technique. Material and methods. The article presents our clinical case with the use of endovascular technique for the treatment of large posttraumatic pseudoaneurysm of the S2 segment of the left subclavian artery using the Bard LifeStream balloon stent graft.Discussion. Currently, direct surgery is considered to be the gold standard of treatment in extracranial aneurysms. Meanwhile, availability of minimally invasive methods allows minimizing the risk by performing endovascular treatment and thus reducing the risk of foreign bodies and infectious complications associated with a large volume of surgical intervention in direct surgery, reducing damage to the brachial plexus, decreasing the number of beddays, and contributing to early rehabilitation measures. The strategy of choice in favor of endovascular treatment should be individual for each patient taking into account such factors as localization, aneurysm size, compression of nearby cranial nerves, and concomitant pathology with high risk of open surgical treatment. Conclusions. Careful selection of patients for endovascular technique will ensure good long-term outcome using all advantages of this technique. At present, it is still relevant and crucial to minimize complications and iatrogenic postoperative lesions in patients with this disease. For this reason, endovascular surgeries should be performed at the stage of specialized medical care by an experienced surgeon.Key words: subclavian artery, false aneurysm, posttraumatic aneurysm, stent graft, endovascular treatment, open surgery, minimally invasive surgery.

Contrast Injection from an Intermediate Catheter Placed in an Intradural Artery is Associated with Contrast-Induced Encephalopathy following Neurointervention.

Contrast-induced encephalopathy can result from neurotoxicity of contrast medium in the affected area. The development of intermediate catheters has allowed guidance of catheters to more distal arteries. This study focused on the association between contrast-induced encephalopathy and contrast injection from an intermediate catheter guided into a distal intradural artery during neurointervention for cerebral aneurysms. We retrospectively reviewed 420 consecutive aneurysms in 396 patients who underwent neurointervention for extracranial aneurysms and unruptured intracranial aneurysms at our institution from February 2012 to January 2023. Patients were divided into a group with contrast-induced encephalopathy and a group without. To identify risk factors for contrast-induced encephalopathy, we compared clinical, anatomic, and procedural factors between groups by multivariate logistic regression analysis and stepwise selection. Among the 396 patients who underwent neurointervention for cerebral aneurysms, 14 (3.5%) developed contrast-induced encephalopathy. Compared with the group without contrast-induced encephalopathy, the group with contrast-induced encephalopathy showed significantly higher rates of patients on hemodialysis, previously treated aneurysms, intradural placement of a catheter for angiography, nonionic contrast medium, and flow-diversion procedures in univariate analyses. Stepwise multivariate logistic regression analysis revealed intradural placement of a catheter for angiography (OR = 40.4; 95% CI, 8.63-189) and previously treated aneurysms (OR = 8.20; 95% CI, 2.26-29.6) as independent predictors of contrast-induced encephalopathy. Contrast injection from an intradural artery and retreatment of recurrent aneurysms were major risk factors for contrast-induced encephalopathy. Attention should be paid to the location of the intermediate catheter for angiography to avoid developing contrast-induced encephalopathy.

Large vertebral artery pseudoaneurysm masquerading as a schwannoma: illustrative case.

Extracranial vertebral aneurysms or pseudoaneurysms are rare and result primarily from trauma. Large pseudoaneurysms can masquerade as mass lesions, making it challenging to identify the correct diagnosis. This is a case report in which a large vertebral pseudoaneurysm posed as a schwannoma and biopsy was attempted. It was later identified as a vascular lesion and treated appropriately with no complications. Vascular etiologies should always be included in the differential diagnosis of spine and nerve pathologies especially lesions that are in the vicinity of major vascular channels such as the transverse foramina of the cervical spine.

Anatomical Variations of the Common Carotid Arteries and Neck Structures of the New Zealand White Rabbit and Their Implications for the Development of Preclinical Extracranial Aneurysm Models

Rabbit models involving neck arteries are of growing importance for the development of preclinical aneurysm models. An optimal understanding of the anatomy is primordial to allow the conception of models while minimizing mortality and morbidity. The aim of this study is to give reliable anatomical landmarks to allow a standardized approach to the neck vessels. We performed a necropsy on nine specimens from ongoing experimental studies. We measured the distance between the origins of the right and left common carotid artery (rCCA/lCCA) and between the rCCA and the manubrium sterni (MS). The structures at risk were described. Female New Zealand White rabbits (NZWR) weighing 3.7 ± 0.3 kg and aged 25 ± 5 weeks were included. The rCCA origin was located 9.6 ± 1.2 mm laterally and 10.1 ± 3.3 mm caudally to the MS. In all specimens, the lCCA originated from the aortic arch, together with the brachiocephalic trunk (BCT), and 6.2 ± 3.1 mm proximally to the rCCA origin. The external and internal jugular veins, trachea and laryngeal nerve were the main structures at risk. The data help to localize both CCAs and their origin to guide surgical approaches with the manubrium sterni as a main landmark. Special attention has to be paid to the trachea, jugular veins and laryngeal nerves.

A novel 3-Fr guiding sheath for transradial access in aneurysm embolization: Technical note.

Neurointervention via transradial access (TRA) is challenging when the radial artery is narrow. We performed aneurysm embolization via TRA using a novel 3-Fr guiding sheath (GS) (Axcelguide; Medikit, Tokyo, Japan) with an outer diameter of only 1.76 mm for patients with a radial artery of inner diameter less than 2 mm, and described the whole procedure and pitfalls as a technical note. Here, we present two patients with radial arteries less than 2 mm. One patient had a narrow neck intracranial aneurysm at the bifurcation of the left vertebral artery and posterior inferior cerebellar artery, which was embolized with the primary coiling technique. The other was a patient with a wide-necked extracranial aneurysm in the cavernous portion of the right internal carotid artery, which was embolized with the transcell technique with stent. We utilized a 3-Fr GS, distal access catheter, and a 0.0165-inch microcatheter for coil embolization. All aneurysms were completely occluded, without neurological or puncture site-related complications including subcutaneous hematoma, radial artery occlusion, and vasospasm. This report provides the first description of neurointervention using a 3-Fr GS. The 3-Fr GS contributed to successful completion of TRA aneurysm embolization without neurological or puncture site-related complications in patients with radial arteries narrower than 2 mm. The 3-Fr GS may be useful to accomplish aneurysmal embolization via TRA even in patients with a small radial artery.

Detection of Subarachnoid Hemorrhage in Computed Tomography Using Association Rules Mining.

Subarachnoid hemorrhage (SAH) is one of the serious strokes of cerebrovascular accidents. There is an approx. 15% probability of spontaneous subarachnoid hemorrhage in all acute cerebrovascular accidents (CVAs). Most spontaneous subarachnoid hemorrhages are caused by ruptures of intracranial aneurysms, accounting for about 85% of all occurrences. About 15% of acute cerebrovascular disorders are caused by spontaneous subarachnoid hemorrhage. This illness is mostly caused by brain/spinal arteriovenous malformations, extracranial aneurysms, and hypertension. Computed tomography (CT) scan is the common diagnostic modality to evaluate SAH, but it is very difficult to identify the abnormality. Thus, automatic detection of SAH is required to recognize the early signs and symptoms of SAH and to provide appropriate therapeutic intervention and treatment. In this article, the gray-level cooccurrence matrix (GLCM) is used to extract useful features from CT images. Then, the New Association Classification Frequent Pattern (NCFP-growth) algorithm is applied, which is based on association rules. Then, it is compared with FP-growth methods with association rules and FP-growth methods without association rules. The experimental results indicate that the suggested approach outperforms in terms of classification accuracy. The proposed approach equates to a 95.2% accuracy rate compared to the conventional data mining algorithm.

165 Antithrombotic Therapy for Aortic and Peripheral Artery Aneurysms: A Systematic Review and Meta-Analysis

Abstract Aim This systematic review and meta-analysis aimed to assess the impact of antithrombotic agents on extracranial aneurysms under surveillance or undergoing intervention. Method Medline, Embase, and CENTRAL databases were searched. Randomised-controlled trials and observational studies investigating the effect of antithrombotic therapy on clinical outcomes for patients with aortic or extracranial peripheral arterial aneurysms were included. Aneurysm growth rate, major adverse cardiovascular or limb events, mortality, endoleaks, re-intervention rates, and other outcomes were captured. Results Fifty-seven studies involving 121,451 patients were included (26 antiplatelets, 12 anticoagulants, 16 any antithrombotic agent(s), 2 intra-operative heparin). Aspirin reduced growth rates of aortic aneurysms under surveillance (mean difference -0.9mm/y, 95%CI -1.74 to -0.07, p=0.03; GRADE certainty: moderate). For aortic aneurysms undergoing intervention, antithrombotics increased 30-day mortality (odds ratio [OR] 2.30, 95%CI 1.51 to 3.51, p<0.001; GRADE certainty: moderate). Antiplatelets reduced long-term all-cause mortality (hazard ratio [HR] 0.84, 95%CI 0.76 to 0.92, p<0.001; GRADE certainty: moderate), whilst anticoagulants increased this risk (HR 1.64, 95%CI 1.14 to 2.37, p=0.008; GRADE certainty: very low). Anticoagulants increased incidence of endoleaks under 3 years, and re-intervention rates (p<0.05 for all). Antithrombotic agents did not significantly affect rupture rates in aortic aneurysms. Meta-analysis was not possible for ruptured aneurysms and popliteal aneurysms. Conclusions There is moderate quality evidence that aspirin reduces aneurysm growth rates. Antiplatelet agents reduced all-cause mortality in aneurysms after intervention; whilst anticoagulants increased this risk, along with endoleaks and re-interventions. Well-designed trials are required to determine therapeutic benefits of antithrombotic agents for patients with aneurysms.

O075 Antithrombotic therapy for aortic and peripheral artery aneurysms: a systematic review and meta-analysis

Abstract Introduction The role of antithrombotic agents in aneurysm progression and outcomes following surgical or endovascular intervention is unclear. Methods A systematic review and meta-analysis was performed. Medline, Embase, and CENTRAL databases were searched. Randomised-controlled trials and observational studies investigating the effect of antithrombotic therapy on clinical outcomes for patients with aortic or extracranial peripheral arterial aneurysms were included. Aneurysm growth rate, major adverse cardiovascular or limb events, mortality, endoleaks, re-intervention rates, and other outcomes were captured. Results Fifty-seven studies involving 121,451 patients were included (26 antiplatelets, 12 anticoagulants, 16 any antithrombotic agent(s), 2 intra-operative heparin). Aspirin reduced growth rates of aortic aneurysms under surveillance (mean difference -0.9mm/y, 95%CI -1.74 to -0.07, p=0.03; GRADE certainty: moderate). For aortic aneurysms undergoing intervention, anti-thrombotics increased 30-day mortality (odds ratio [OR] 2.30, 95%CI 1.51 to 3.51, p<0.001; GRADE certainty: moderate). Antiplatelets reduced long-term all-cause mortality (hazard ratio [HR] 0.84, 95%CI 0.76 to 0.92, p<0.001; GRADE certainty: moderate), whilst anticoagulants increased this risk (HR 1.64, 95%CI 1.14 to 2.37, p=0.008; GRADE certainty: very low). Anticoagulants increased incidence of endoleaks under 3 years, and re-intervention rates (p<0.05 for all). Antithrombotic agents did not significantly affect rupture rates in aortic aneurysms. Meta-analysis was not possible for ruptured aneurysms and popliteal aneurysms. Conclusion There is moderate quality evidence that aspirin reduces aneurysm growth rates. Antiplatelet agents reduced all-cause mortality in aneurysms after intervention; whilst anticoagulants increased this risk, along with endoleaks and re-interventions. Well-designed trials are required to determine therapeutic benefits of antithrombotic agents for patients with aneurysms. Take-home message Antiplatelets may have a role in reducing aneurysm growth rates and all-cause mortality; whilst anticoagulants are associated with increased mortality, endoleaks, and re-interventions. Well-designed trials are required to determine therapeutic benefits of antithrombotic agents for patients with aneurysms.

Intracranial Aneurysms in Loeys-Dietz Syndrome: A Multicenter Propensity-Matched Analysis.

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by a classic triad of hypertelorism, bifid uvula and/or cleft palate, and generalized arterial tortuosity. There are limited data on the prevalence and rupture risk of intracranial aneurysms (IAs) in the setting of LDS, with no established guidelines. To analyze the prevalence and rupture risk of IA in LDS. Electronic medical records of patients with a confirmed diagnosis of LDS and available cerebrovascular imaging were reviewed. Patients were divided into 2 groups based on the presence of IA. Unmatched and propensity-matched analyses were used to identify potential risk factors for aneurysm formation. Records of 1111 patients were screened yielding a total of 60 patients with a diagnosis of LDS. Eighteen (30%) patients had IA, 4 (22.2%) of whom had multiple aneurysms for a total of 24 IAs. Twenty-three (95.8%) aneurysms were located in the anterior circulation; none of them were ruptured. On unmatched analysis, age ( P = .015), smoking history ( P = .034), hypertension ( P = .035), and number of extracranial aneurysms ( P < .001) were significantly higher in patients with IA. After matching for age, sex, race, stroke history, family history, and extracranial aneurysms, smoking history ( P = .009) remained significant. Patients with LDS have an increased risk of IAs, especially with a history of smoking. The prevalence rate of IAs in our series was 30%. Screening imaging should be considered at diagnosis, and patients should be encouraged to abstain from smoking. Further studies are needed to elucidate the risk of IA rupture and treatment considerations in this unique population.

Stereotactic direct-coiling of aneurysms\u2014a feasibility study

Aim of the studyEndovascular coiling has gained worldwide acceptance in the management of intracranial aneurysms. However, not all aneurysms can be coiled. Direct aneurysm puncture with aneurysm thrombosis has been performed, using coils for extracranial aneurysms and iron filings for intracranial aneurysms. Therefore, the feasibility of stereotactic aneurysm coiling with direct aneurysm puncture using Nester-coils was studied in an in vitro model.Methods and findingsTwenty-eight aneurysms measuring 9–21 mm in diameters (median 14 mm) were made using 0.1 mm vinyl film that was connected to a monometer with 73 cm of water column. Twenty-three aneurysms were coiled through direct puncture of the aneurysms using a stereotactic frame. Five were coiled using a hand-held probe carrier.Statistical analysis of the data was conducted by data analysis feature of Microsoft Excel.FindingsThe study showed that needle puncture of the aneurysm and coiling of the aneurysm through the needle can be done with ease and without any significant fluid leak from the puncture site. It also shows that the coil will stay within the aneurysm without entering the neck. The study also shows that this method can be done using free-hand technique. Furthermore, it shows that the probe holder for the needle can also be used as an aneurysm stabilizer and as a tamponade.

An Unusual Association of Hemihypertrophy with Extracranial and Intracranial Aneurysms.

An Unusual Association of Hemihypertrophy with Extracranial and Intracranial Aneurysms.

Clinical Analysis of Interventional Therapy for Eight Cases of Extracranial ICA Aneurysm

Objective:To explore the interventional therapy and clinical efficacy of extracranial ICA aneurysm.Methods:The clinical data of eight patients with extracranial ICA aneurysm treated by interventional stent implantation from December 2014 to February 2018 in the Neurosurgery Department of the Third Hospital of Mianyang were analyzed. And this research was a retrospective analysis. All patients underwent digital subtraction angiography (DSA) and were diagnosed with extracranial carotid artery aneurysm. These patients, therefore, were treated with interventional stent implantation.Results:Interventional treatment was successfully conducted on all eight patients. In eight patients, the aneurysm cavity was not developed immediately after angiography, and in one case, the aneurysm cavity was developed with coil-assisted embolization. All the internal carotid arteries were well developed, with no complications such as intraoperative rupture, bleeding and thrombosis occur. Follow-up for three months to two years showed that the patients recovered well, the GOS score was 4 points for patients with cerebral infarction, and the rest reached five points. Follow-up CTA showed no signs of aneurysm recurrence or ICA restenosis.Conclusion:Interventional stent placement is a preferable and relatively safe method for the treatment of extracranial carotid artery aneurysm with less trauma and short operation time.

Endovascular treatment of extracranial dissecting aneurysms of cervical arteries

Dissecting aneurysms of extracranial cervical arteries are a rare vascular pathology. To date, there is no consensus on the choice of optimal surgical approach for these aneurysms. To evaluate the effectiveness of endovascular treatment of various extracranial dissecting aneurysms. There were 19 patients with 21 extracranial dissecting aneurysms for the period from January 1, 2013 to October 19, 2020. Clinical examination, ultrasound and neuroimaging data were considered to determine surgical intervention. Nineteen patients underwent 20 intravascular interventions: aneurysm embolization with detachable coils with stent-assistance (n=9), flow-diverting stent implantation (n=5), arterial reconstruction with a stent for carotid stenting (n=3), aneurysm embolization with balloon assistance (n=1), aneurysm embolization with detachable coils without assistance (n=2). There were no complications. All patients were discharged without neurological impairment after 1-5 days. Long-term results of control angiography were analyzed within 1-19 months in 12 patients. All aneurysms were completely occluded. Asymptomatic occlusion of flow-diverting stent together with aneurysm occurred in 1 patient with low compliance to antiplatelet therapy. Other 6 patients are scheduled for elective angiography. Extracranial dissecting aneurysms of cervical arteries require vigilance due to their rare occurrence and risk of severe complications. In our opinion, intravascular interventions are advisable for these patients as effective and safe procedures.

Genetic and heritable considerations in patients or families with both intracranial and extracranial aneurysms.

Genetic and heritable considerations in patients or families with both intracranial and extracranial aneurysms.

Ruptured Popliteal Artery Aneurysm Complicated with Acute Respiratory Distress Syndrome Secondary to SARS-CoV-2 Infection

We herein report a rare case of the ruptured popliteal artery aneurysm in an 89-year-old man, whose recovery after surgical treatment was complicated with acute respiratory distress syndrome secondary to confirmed infection with SARS-CoV-2. Presenting symptoms, patient's comorbidities, and postoperative course complicated with cardiac and respiratory failure leading to adverse outcome are discussed in this case report.

HIV-associated Extracranial Arterial Aneurysms: A Systematic Review

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been found to be associated with an increased risk of cardiovascular disease, and the development of arterial aneurysms in particular, intracranial aneurysms. In this review, we will review the reported HIV-associated extracranial aneurysms (HECAA) and their possible association with HIV/AIDS. We will discuss the proposed pathogenetic pathways leading to arterial aneurysms. HECAA, a subset of HIV/AIDS-associated arterial aneurysm (HAA), is more commonly seen in the adult population and in those with lower CD4+ T-cell counts and higher HIV viral loads. There also appears to be an advantage to early diagnosis of HECAA. There are viable treatment options available, as 61.4% of patients with HECAA underwent a corrective procedure. Furthermore, the mortality rate of 1.75% in HECAA was much lower when compared to HICAA.

3:00 PM Abstract No. 91 Association of hereditary hemorrhagic telangiectasia with cerebral and extracerebral arterial aneurysms: experience from a single center of hereditary hemorrhagic telangiectasia excellence

Arterial aneurysms are increasingly recognized as part of the hereditary hemorrhagic telangiectasia (HHT) phenotype, however, literature on this association is limited. This retrospective study describes the incidence of known intra- and extracranial aneurysms in a large cohort of patients with HHT or HHT-associated genetic mutation and identifies factors predictive of aneurysm presence. Institutional review board approval was obtained. In our institution’s HHT database, patients with either definite HHT by clinical criteria (Curacao score of 3 or 4) and/or HHT-associated mutation (ENG, ACVRL1, SMAD4, or GDF2) were identified. 401 patients were included (mean age, 47 years; range, 3-99 years); 244 (61%) were female. 365 had a Curacao score of 3 (n = 201) or 4 (n = 164). Electronic medical records were reviewed for imaging/clinical characteristics of arterial aneurysms. Statistical analysis was performed using IBM SPSS v25. 49/401 patients (12.2%) had at least one aneurysm. 17 (4.2%) were intracranial, of which 10 were treated. 21 (5.2%) had a visceral aneurysm, including splenic (n = 14, 3 treated), renal (n = 3), hepatic (n = 2), and pancreatic (n = 2). 10 (2.5%) had a cardiac/aortic aneurysm, and 7 (1.7%) had a pulmonary aneurysm. 16 patients (4.0%) had more than one aneurysm; 80 aneurysms total were documented in this cohort. 17 patients with aneurysm had an HHT-associated mutation, distributed as follows: ACVRL1 (n = 10), ENG (n = 5), GDF2 (n = 1), and SMAD4 (n = 1). Binomial logistic regression was performed to ascertain the effects of Curacao score, age, gender and genetic mutation on the likelihood that participants have at least one arterial aneurysm. Of the seven predictor variables, Curacao score, age, ACVRL1 and GDF2 were statistically significant (P = 0.007, 0.002, 0.007, and 0.014, respectively). Furthermore, ACVRL1 mutation was associated with a higher number of aneurysms in any one individual (P = 0.017) In this cohort of patients with HHT and/or HHT-associated mutation, higher Curacao score, age, ACVRL1, and GDF2 are associated with presence of at least one aneurysm in patients with HHT. ACVRL1 mutation is associated with a higher number of aneurysms in any one individual.