Intracranial Aneurysm Is Associated with High Intracranial Artery Tortuosity

Kim, Bum Joon; Lee, Sung Ho; Kwun, Byeong Duk; Kang, Hyun Goo; Hong, Kyung Soon; Kang, Dong‐Wha; Kim, Jong Seung; Kwon, Sun U.

doi:10.1016/j.wneu.2018.01.196

Cited by 20 publications

(11 citation statements)

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“…Previous studies have reported a high MCA TI in MCA aneurysms 6 and a strong correlation between BA or cervical artery tortuosity and IA formation. [7][8][9][10] In addition, our study showed higher VA tortuosity and average TI scores across all arterial segments in the IA group than in the control group. Although studies have investigated the relationship between VA tortuosity and aneurysm, they were focused on abdominal aneurysms rather than IAs.…”

Section: Discussionsupporting

confidence: 52%

“…3 Arterial tortuosity is a hallmark of inherited arteriopathy, including fibromuscular dysplasia, and is associated with a high incidence of IAs. 1,4,5 Based on previous studies, the severe tortuosity of a cerebral vessel has been strongly associated with the occurrence [6][7][8][9][10] and outcome of the IA. 11,12 Various methods have been proposed for the analysis of tortuosity in two-dimensional (2D) and three-dimensional (3D).…”

Section: Introductionmentioning

confidence: 99%

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How Cerebral Vessel Tortuosity Affects Development and Recurrence of Aneurysm: Outer Curvature versus Bifurcation Type

et al. 2021

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Background and Purpose Previous studies have assessed the relationship between cerebral vessel tortuosity and intracranial aneurysm (IA) based on two-dimensional brain image analysis. We evaluated the relationship between cerebral vessel tortuosity and IA according to the hemodynamic location using three-dimensional (3D) analysis and studied the effect of tortuosity on the recurrence of treated IA.Methods We collected clinical and imaging data from patients with IA and disease-free controls. IAs were categorized into outer curvature and bifurcation types. Computerized analysis of the images provided information on the length of the arterial segment and tortuosity of the cerebral arteries in 3D space.Results Data from 95 patients with IA and 95 controls were analyzed. Regarding parent vessel tortuosity index (TI; P<0.01), average TI (P<0.01), basilar artery (BA; P=0.02), left posterior cerebral artery (P=0.03), both vertebral arteries (VAs; P<0.01), and right internal carotid artery (P<0.01), there was a significant difference only in the outer curvature type compared with the control group. The outer curvature type was analyzed, and the occurrence of an IA was associated with increased TI of the parent vessel, average, BA, right middle cerebral artery, and both VAs in the logistic regression analysis. However, in all aneurysm cases, recanalization of the treated aneurysm was inversely associated with increased TI of the parent vessels.Conclusions TIs of intracranial arteries are associated with the occurrence of IA, especially in the outer curvature type. IAs with a high TI in the parent vessel showed good outcomes with endovascular treatment.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

How Cerebral Vessel Tortuosity Affects Development and Recurrence of Aneurysm: Outer Curvature versus Bifurcation Type

et al. 2021

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“…Another finding of our study was the significant association of SOAM, TI, PAD and ICM with the presence of BA aneurysm. Kim et al in their study [22] also found such correlation. It was shown before for aortic [10] and splenic artery [11] aneurysms.…”

Section: Discussionmentioning

confidence: 54%

Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development

et al. 2020

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Objectives We analysed tortuosity of basilar artery (BA) to determine its relationship with the presence of aneurysm. Methods We retrospectively analysed 71 patients with BA aneurysms along with 71 age- and risk factors-matched control patients without BA aneurysm. From patients’ medical records, we obtained their history including previous and current diseases and medications. For each patient, we calculated relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD) and inflexion count metrics (ICM). We used t-test and Mann-Whitney U test for continuous variables and χ2 test for dichotomised variables. To find independent predictors of BA aneurysm, we employed logistic regression analysis. Results We found significant positive correlation between age and SOAM (R = 0.195, p = 0.02) and PAD (R = 0.199, p = 0.018). Our study also showed that patients with BA aneurysm had significantly higher SOAM (0.21 ± 0.16 vs. 0.11 ± 0.08; p < 0.01), PAD (0.30 ± 0.19 vs. 0.18 ± 0.11; p < 0.01), TI (0.23 ± 0.23 vs. 0.10 ± 0.16; p < 0.01) and ICM (0.20 ± 0.16 vs. 0.15 ± 0.11; p = 0.045). In multivariate logistic regression analysis, after adjustment for all possible confounders, SOAM (OR = 1.086; 95% CI 1.046–1.136; p < 0.01) and TI (OR = 1.004; 95%C: 1.002–1.006; p < 0.01) remained independently associated with higher risk of BA aneurysm. Conclusions Increased tortuosity of BA is associated with higher risk of its aneurysm development. Key Points • Basilar artery sum of angle metrics and product of angle distance are correlated with age. • Basilar artery tortuosity is independently associated with higher risk of its aneurysm development. • Basilar artery tortuosity is positively correlated with its diameter and bifurcation angle.

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“…However, we achieved contradictory results for SOAM. Association between higher tortuosity and intracranial aneurysm was shown in terms of BA [14] and VA [16], as well as in terms of the splenic artery [12] and aorta [11]. One of the explanations for such correlation could be changes in hemodynamics caused by increase in tortuosity.…”

Section: Discussionmentioning

confidence: 99%

“…As tortuosity promotes hemodynamic changes in blood flow, it can lead to the development of aneurysms. Such association was found in terms of the aorta [11] and splenic artery [12], as well as in brain arteries, such as the internal carotid artery (ICA) [13], basilar artery (BA) [14], middle cerebral artery (MCA) [15], and vertebral artery [16]. Our previous study suggested that tortuosity of the anterior cerebral artery might play a role in anterior communicating artery aneurysm rupture [17].…”

Section: Introductionmentioning

confidence: 99%

Tortuosity of the Internal Carotid Artery and Its Clinical Significance in the Development of Aneurysms

Kliś

Krzyżewski

Kwinta

et al. 2019

JCM

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Tortuosity of blood vessels is a common angiographic finding that may indicate systemic disease and can be correlated with vascular pathologies. In this work, we determined whether patients with and without internal carotid artery (ICA) aneurysm presented with differences in its tortuosity descriptors. We retrospectively analysed data of 298 patients hospitalized between January 2014 and June 2018. For each patient’s imaging data, we extracted a curve representing the ICA course and measured its Relative Length (RL), Sum of Angle Metrics (SOAM), Product of Angle Distance (PAD), Triangular Index (TI), and Inflection Count Metrics (ICM). We found that patients with an ICA aneurysm had significantly lower RL (0.46 ± 0.19 vs. 0.51 ± 0.17; p = 0.023) and significantly higher SOAM (0.39 ± 0.21 vs. 0.32 ± 0.21 p = 0.003), PAD (0.38 ± 0.19 vs. 0.32 ± 0.21; p = 0.011), TI (0.30 ± 0.11 vs. 0.27 ± 0.14; p = 0.034), and ICM (0.30 ± 0.16 vs. 0.22 ± 0.12; p < 0.001). We found that that patients who presented with a subarachnoid hemorrhage had significantly higher PAD (0.46 ± 0.22 vs. 0.35 ± 0.20; p = 0.024). In conclusion, higher tortuosity of ICA is associated with ICA aneurysm presence.

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Intracranial Aneurysm Is Associated with High Intracranial Artery Tortuosity

Cited by 20 publications

References 20 publications

How Cerebral Vessel Tortuosity Affects Development and Recurrence of Aneurysm: Outer Curvature versus Bifurcation Type

How Cerebral Vessel Tortuosity Affects Development and Recurrence of Aneurysm: Outer Curvature versus Bifurcation Type

Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development

Tortuosity of the Internal Carotid Artery and Its Clinical Significance in the Development of Aneurysms

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