Arterial distensibility in patients with ruptured and unruptured intracranial aneurysms: Is it a predisposing factor for rupture risk?

Duşak, Abdurrahim; Kamaşak, Kaan; Göya, Cemil; Adin, Mehmet Emin; Elbey, Mehmet Ali; Bilici, Aslan

doi:10.12659/msm.889032

Cited by 8 publications

(6 citation statements)

References 46 publications

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“…Appropriate sealing determines the success and durability of EVAR. It has recently been shown that the measurement of arterial distensibility is a significant predictor of rupture risk independently of aneurysm diameter [ 4 , 18 ]. Therefore, precise characterization of aortic baseline and follow-up dimensions will be crucial in studies aimed at assessing the wall morphological and functional differences before EVAR.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Aortic Distensibility Measurement Using CT in Patients with Abdominal Aortic Aneurysm: Reproducibility and Clinical Relevance

Zha

Peng

et al. 2017

BioMed Research International

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Purpose. To investigate the reproducibility of aortic distensibility (D) measurement using CT and assess its clinical relevance in patients with infrarenal abdominal aortic aneurysm (AAA). Methods. 54 patients with infrarenal abdominal aortic aneurysm were studied to determine their distensibility by using 64-MDCT. Aortic cross-sectional area changes were determined at two positions of the aorta, immediately below the lowest renal artery (level 1.) and at the level of its maximal diameter (level 2.) by semiautomatic segmentation. Measurement reproducibility was assessed using intraclass correlation coefficient (ICC) and Bland-Altman analyses. Stepwise multiple regression analysis was performed to assess linear associations between aortic D and anthropometric and biochemical parameters. Results. A mean distensibility of Dlevel 1. = (1.05 ± 0.22) × 10−5 Pa−1 and Dlevel 2. = (0.49 ± 0.18) × 10−5 Pa−1 was found. ICC proved excellent consistency between readers over two locations: 0.92 for intraobserver and 0.89 for interobserver difference in level 1. and 0.85 and 0.79 in level 2. Multivariate analysis of all these variables showed sac distensibility to be independently related (R2 = 0.68) to BMI, diastolic blood pressure, and AAA diameter. Conclusions. Aortic distensibility measurement in patients with AAA demonstrated high inter- and intraobserver agreement and may be valuable when choosing the optimal dimensions graft for AAA before endovascular aneurysm repair.

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Section: Discussionmentioning

confidence: 99%

Quantitative Aortic Distensibility Measurement Using CT in Patients with Abdominal Aortic Aneurysm: Reproducibility and Clinical Relevance

Zha

Peng

et al. 2017

BioMed Research International

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“…Major risk factors for intraoperative complications include underlying poor vascular strength, misplacement of catheter, guidewire, and/or microcoils, and excessive aneurysm compactness [2,27,28]. Compact embolization of distal RICABF will increase the luminal tension and cause subsequent rupture and bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…This vascular malformation is very likely to rupture in up to 50% of patients [1], and only a few risk factors for rupture has been identified so far [2,3]. Ruptured ICA results in a number of cerebrovascular complications associated with high morbidity [4–6], leading to a high mortality rate [7–9].…”

Section: Introductionmentioning

confidence: 99%

“…Intracranial aneurysms (ICA) are localized, pathological dilation or ballooning of a cerebral artery, with an incidence of 2–5% in the general population [ 1 ]. This vascular malformation is very likely to rupture in up to 50% of patients [ 1 ], and only a few risk factors for rupture has been identified so far [ 2 , 3 ]. Ruptured ICA results in a number of cerebrovascular complications associated with high morbidity [ 4 – 6 ], leading to a high mortality rate [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Endovascular coil embolization of aneurysm neck for the treatment of ruptured intracranial aneurysm with bleb formation

Zhang

et al. 2014

Med Sci Monit

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BackgroundRuptured intracranial aneurysm (ICA) with bleb formation (RICABF) is a special type of ruptured ICA. However, the exact role and effectiveness of endovascular coil embolization (ECE) in RICABF is unknown.We aimed to investigate the effectiveness and safety of ECE of aneurysm neck for RICABF treatment.Material/MethodsWe retrospectively assessed consecutive patients who were hospitalized in our endovascular intervention center between October 2004 and May 2012. Overall, 86 patients underwent ECE of aneurysm neck for 86 RICABF. Treatments outcomes included secondary rupture/bleeding rate, aneurysm neck embolization rate, residual/recurrent aneurysm, intraoperative incidents, and post-embolization complications, as well as improvements in the Glasgow outcome scale (extended) (GOS-E).ResultsComplete occlusion was achieved in 72 aneurysms (72/86, 83.7%), while 12 aneurysms (12/86, 14.0%) had a residual neck, and 2 aneurysms (2/86, 2.3%) had a residual aneurysm. The postoperative GOS-E was 3 in 3 patients (3.5%), 4 in 10 patients (11.6%), and 5 in 73 patients (84.9%). Follow-up angiography was performed in all patients (mean 9.0 months, interquartile range of 9.0). Recurrence was found in 3 patients (3/86, 3.5%). No aneurysm rupture or bleeding was reported.ConclusionsOur mid-term follow-up study showed that ECE of aneurysm neck was an effective and safe treatment modality for RICABF. The long-term effectiveness and safety of this interventional radiology technique need to be investigated in prospective and comparative studies.

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“…Autopsy studies have shown an occurrence of unruptured intracranial aneurysms (UIAs) incidences in approximately 5 percent of all performed autopsies 6,13) . 6 of 100,000 patients will have ruptured aneurysm induced subarachnoid hemorrhage each year in the USA 1,17) .…”

Section: Introductionmentioning

confidence: 99%

Analysis of Predisposing Factors of the Treatment of Patients with Unruptured Intracranial Aneurysms

Lee

Park

et al. 2018

J Neurointensive Care

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ObjectiveTo investigate the factors that influence the determination of treatment of unruptured intracranial aneurysms (UIAs), we retrospectively compared various well-known risk factors that are associated with future rupture for treated and observed groups. MethodsBetween January 2006 and December 2016, a total of 279 patients treated UIAs with surgical clipping or coil embolization have been included in this study. In the same period, 100 patients did undergo transfemoral cerebral angiograms and were initially managed with observation. Aneurysmal characteristics and patinets were compared between the treated and the observed group. The association between these factors and the decision of treatment was performed using a multivariate logistic regression analysis. Results279 patients with treated unruptured aneurysms and the observation group included 100 patients with unruptured aneurysms. A multivariate study revealed that young age (OR=0.959 / p=0.001), high aneurysms height, (OR=1.906 / p=0.002), daughter sac (OR=4.072 / p=0.001), location of aneurysms (anterior communicating artery (OR=3.729 / p=0.022) and middle cerebral artery bifurcation (OR=4.110 / p=0.009) were significantly associated with the treatment group when compared to the observation group. ConclusionYoung age, a small aspect ratio, a large aneurysmal height, a daughter sac, and the location of aneurysm were strongly associated with the treatment of unruptured aneurysms.

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Arterial distensibility in patients with ruptured and unruptured intracranial aneurysms: Is it a predisposing factor for rupture risk?

Cited by 8 publications

References 46 publications

Quantitative Aortic Distensibility Measurement Using CT in Patients with Abdominal Aortic Aneurysm: Reproducibility and Clinical Relevance

Quantitative Aortic Distensibility Measurement Using CT in Patients with Abdominal Aortic Aneurysm: Reproducibility and Clinical Relevance

Endovascular coil embolization of aneurysm neck for the treatment of ruptured intracranial aneurysm with bleb formation

Analysis of Predisposing Factors of the Treatment of Patients with Unruptured Intracranial Aneurysms

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