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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1339144

Risk analysis of intracranial aneurysm rupture based on arterial segment origin Authors：

Provisionally accepted
Junqiang Feng Junqiang Feng 1Yudi Tang Yudi Tang 1Wei You Wei You 1Yuhua Jiang Yuhua Jiang 1Zhengkun Xu Zhengkun Xu 2Yan Zhao Yan Zhao 3Xinke Liu Xinke Liu 1Lv Jian Lv Jian 1Peng Liu Peng Liu 1Haining Wei Haining Wei 4Mahmud Mossa-Basha Mahmud Mossa-Basha 5Youxiang Li Youxiang Li 1Yang Wang Yang Wang 1*Chengcheng Zhu Chengcheng Zhu 5
  • 1 Capital Medical University, Beijing, Beijing Municipality, China
  • 2 Hebei University of Technology, Beichen District, Tianjin Municipality, China
  • 3 University of Science and Technology Beijing, Beijing, Beijing Municipality, China
  • 4 Tsinghua University, Beijing, Beijing, China
  • 5 University of Washington, Seattle, Washington, United States

The final, formatted version of the article will be published soon.

    Background and Objectives Intracranial aneurysm’s (IA) rupture risk is related to its arterial origin, but whether the different segment of the artery has different risk and act as an independent risk factor, is still unknown. Our study aims to investigate the rupture risk of IAs in different artery segment in a large Chinese cohort. Methods Imaging and clinical data of consecutive patients with IAs diagnosed by CTA from January 2013 to December 2022 were collected. Two neuroradiologists independently identified ruptured and unruptured IAs based on imaging and medical record. Internal carotid artery(ICA), middle cerebral artery(MCA), anterior cerebral artery(ACA), vertebral artery(VA) and posterior cerebral artery(PCA) were segmented according to Bouthillier and Fischer Segmentation Methods. Stenoses of proximal parent vessel were evaluated and documented. The Institutional Review Board (IRB) at Beijing Tiantan Hospital approved this retrospective study. Results A total of 3,837 aneurysms (median size 3.5mm [IQR 2.6-5.1mm]; 532 ruptured) were included in this study, from 2,968 patients (mean age 57 [IQR 50-64]; 1,153 male). Ruptured aneurysms were most commonly located in the PICA (52.9%), Acom (33.8%), other locations (33.3%), ACA (22.4%), and BA (21.4%). The locations with the highest likelihood of rupture were the C7 ICA (21.3%), M2 MCA (24.0%), distal MCA (25.0%), and A2 ACA (28.1%). IAs originating from the C7 (p<0.001), dM1 (p=0.022), and dA1 (p=0.021) segments were independent risk factors for rupture. IAs without stenosis of the proximal parent vessel were associated with a higher risk of rupture (p=0.023). Conclusions There are unique associations between aneurysm origin from various arterial segments. Aneurysms origin from AcoA, BA, PICA, A2, dA, C7 and M2 indicate higher rupture risk. Aneurysms originating from C4, C5 and C6 indicate a lower rupture risk. C7 IAs, AcoA IAs and PICA IAs seems to be an independent risk factor.

    Keywords: Aneurysm, Aneurysm rupture risk, aneurysm rupture, Risk Assessment, CT angiography

    Received: 15 Nov 2023; Accepted: 31 Jul 2024.

    Copyright: © 2024 Feng, Tang, You, Jiang, Xu, Zhao, Liu, Jian, Liu, Wei, Mossa-Basha, Li, Wang and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yang Wang, Capital Medical University, Beijing, 100069, Beijing Municipality, China

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