Intracranial Arterial Tortuosity According to the Characteristics of Intracranial Aneurysms

Ryu, Jiwook; Kim, Bum Joon; Lee, Kyung Mi; Kim, Hyug Gi; Choi, Seok Keun; Kim, Eui Jong; Lee, Sung Ho; Chang, Dae Il; Kwun, Byung Duk

doi:10.1016/j.wneu.2018.09.034

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…27 Ryu et A B C D al. 12 suggested a correlation between aneurysm rupture and tortuosity based on the association between BA tortuosity and aneurysm growth in their study. Another study showed no association between cervical artery tortuosity and rupture status of IAs.…”

Section: Discussionmentioning

confidence: 98%

“…Studies have investigated the effects of vessel tortuosity on the outcome of IA, and the relationship between tortuosity and rupture risk is debated. 9,11,12,26 Abdominal aortic tortuosity increases the risk of abdominal aortic aneurysm rupture. 27 Ryu et A B C D al.…”

Section: Discussionmentioning

confidence: 99%

“…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). 1,13,14 Although 3D analysis of the tortuosity is more accurate than 2D analysis, previous studies usually used 2D analysis.…”

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: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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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“…The increased vascular tortuosity subsequently results in vascular damage (vascular dissection) and possibly subarachnoid hemorrhage (a positive association between SAH and frontal tortuosity ratio was identified, r =0.233, P =0.042), indicating that increased vascular tortuosity may increase the risk of rupture of vascular dissection. In a previous study, basilar artery tortuosity showed a positive correlation with intracranial aneurysm size, suggesting that tortuosity may increase hemodynamic instability and aneurysm growth 31 . Vertebral artery tortuosity has also been found to be an independent risk factor for cervical artery dissection, indicating that arterial tortuosity may weaken the cervical vascular structure because of its influence on hemodynamics 32 .…”

Section: Discussionmentioning

confidence: 96%

“…In a previous study, basilar artery tortuosity showed a positive correlation with intracranial aneurysm size, suggesting that tortuosity may increase hemodynamic instability and aneurysm growth. 31 Vertebral artery tortuosity has also been found to be an independent risk factor for cervical artery dissection, indicating that arterial tortuosity may weaken the cervical vascular structure because of its influence on hemodynamics. 32 Therefore, maintaining hemodynamic stability might be beneficial for patients with high VBA tortuosity.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of the Etiology of Intracranial Vertebral Artery Dissection and Carotid Artery Dissection

et al. 2023

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Background: Both extrinsic (trauma or violent movement) and intrinsic (structural abnormality, atherosclerosis, or hemodynamic instability) factors may result in arterial dissection. The role of these factors in the origin or progression of dissection remains unclear. This study aimed to characterize the clinical features, radiologic features, and outcomes of intracranial vertebral artery dissection compared with carotid artery dissection and to determine the major causative factors. Methods: Consecutive patients with craniocervical dissection (n=127) were retrospectively analyzed. Patients with intracranial vertebral artery dissection (n=77) and those with carotid artery dissection (n=35) were compared with respect to patient age, sex, cerebrovascular risk factors, laboratory indices, and radiologic features. Results: Intracranial vertebral artery dissection was the most common craniocervical arterial dissection in our cohort (n=77, 60.6%). Body mass index in the intracranial vertebral artery dissection group was significantly greater than that in carotid artery dissection group. Clinical manifestations of intracranial vertebral artery dissection included ischemic stroke (37.7%), dizziness or vertigo (39.0%), and headache or neck pain (44.2%). Two patients had a definite history of trauma. The frontal and lateral tortuosity ratios of the vertebral basilar artery were significantly greater while the vertex angle was smaller in the intracranial vertebral artery dissection group compared with carotid artery dissection group. A positive correlation between the tortuosity ratios and subarachnoid hemorrhage and a significant inverse correlation between the tortuosity ratios and lipid parameters (high-density lipoprotein; apolipoprotein A1) were identified. Conclusions: Intrinsic causes may play a more important role in the development of intracranial vertebral artery dissection than carotid artery dissection.

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Neurovascular findings in children and young adults with Loeys-Dietz syndromes: Informing recommendations for screening

LoPresti

Ghali

Srinivasan

et al. 2020

Journal of the Neurological Sciences

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Intracranial Arterial Tortuosity According to the Characteristics of Intracranial Aneurysms

Cited by 5 publications

References 22 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

A Comparative Study of the Etiology of Intracranial Vertebral Artery Dissection and Carotid Artery Dissection

Neurovascular findings in children and young adults with Loeys-Dietz syndromes: Informing recommendations for screening

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