How Cerebral Vessel Tortuosity Affects Development and Recurrence of Aneurysm: Outer Curvature versus Bifurcation Type
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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.
Abstract
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.
참고문헌 (32)
- Ciurică S, "Arterial tortuosity", Hypertension, 73, pp.951~960 (2019)
- Hughes AD, "Quantification of topological changes in retinal vascular architecture in essential and malignant hypertension", J Hypertens, 24, pp.889~894 (2006)
- Dolan JM, "High wall shear stress and spatial gradients in vascular pathology : a review", Ann Biomed Eng, 41, pp.1411~1427 (2013)
- Southerland AM, "Shared associations of nonatherosclerotic, large-vessel, cerebrovascular arteriopathies:considering intracranial aneurysms, cervical artery dissection, moyamoya disease and fibromuscular dysplasia", Curr Opin Neurol, 26, pp.13~28 (2013)
- Lather HD, "Prevalence of intracranial aneurysm in women with fibromuscular dysplasia : a report from the US Registry for Fibromuscular Dysplasia", JAMA Neurol, 74, pp.1081~1087 (2017)
- Kliś KM, "Computer-aided analysis of middle cerebral artery tortuosity : association with aneurysm development", J Neurosurg, pp.1~7 (2018)
- Kliś KM, "Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development", Eur Radiol, 30, pp.5625~5632 (2020)
- Kim BJ, "Intracranial aneurysm is associated with high intracranial artery tortuosity", World Neurosurg, 112, pp.e876~e880 (2018)
- Labeyrie PE, "Cervical artery tortuosity is associated with intracranial aneurysm", Int J Stroke, 12, pp.549~552 (2017)
- Kliś KM, "Tortuosity of the internal carotid artery and its clinical significance in the development of aneurysms", J Clin Med, 8, pp.237~ (2019)
- Krzyżewski RM, "Analysis of anterior cerebral artery tortuosity : association with anterior communicating artery aneurysm rupture", World Neurosurg, 122, pp.e480~e486 (2019)
- Ryu J, "Intracranial arterial tortuosity according to the characteristics of intracranial aneurysms", World Neurosurg, 120, pp.e1185~e1192 (2018)
- Bullitt E, "Measuring tortuosity of the intracerebral vasculature from MRA images", IEEE Trans Med Imaging, 22, pp.1163~1171 (2003)
- Kim JK, "Sum of the curve indices for estimating the vascular tortuousness of the internal carotid artery", Neurointervention, 4, pp.101~106 (2009)
- Kulcsár Z, "Hemodynamics of cerebral aneurysm initiation : the role of wall shear stress and spatial wall shear stress gradient", AJNR Am J Neuroradiol, 32, pp.587~594 (2011)
- Jeong W, "Hemodynamics of cerebral aneurysms : computational analyses of aneurysm progress and treatment", Comput Math Methods Med, 2012, pp.782801~ (2012)
- Vorobtsova N, "Effects of vessel tortuosity on coronary hemodynamics : an idealized and patient-specific computational study", Ann Biomed Eng, 44, pp.2228~2239 (2016)
- Roy D, "Endovascular treatment of unruptured aneurysms", Stroke, 32, pp.1998~2004 (2001)
- Spangler KM, "Arteriolar tortuosity of the white matter in aging and hypertension. A microradiographic study", J Neuropathol Exp Neurol, 53, pp.22~26 (1994)
- Han HC, "Twisted blood vessels: symptoms, etiology and biomechanical mechanisms", J Vasc Res, 49, pp.185~197 (2012)
- Jackson ZS, "Partial off-loading of longitudinal tension induces arterial tortuosity", Arterioscler Thromb Vasc Biol, 25, pp.957~962 (2005)
- Signorelli F, "Hemodynamic stress, inflammation, and intracranial aneurysm development and rupture: a systematic review", World Neurosurg, 115, pp.234~244 (2018)
- Soldozy S, "The biophysical role of hemodynamics in the pathogenesis of cerebral aneurysm formation and rupture", Neurosurg Focus, 47, pp.E11~ (2019)
- Virgilio F, "Vertebral tortuosity index in patients with non-connective tissue disorder-related aneurysm disease", Eur J Vasc Endovasc Surg, 53, pp.425~430 (2017)
- Pico F, "Pathophysiology, presentation, prognosis, and management of intracranial arterial dolichoectasia", Lancet Neurol, 14, pp.833~845 (2015)
- Krzyżewski RM, "Increased tortuosity of ACA might be associated with increased risk of ACoA aneurysm development and less aneurysm dome size : a computer-aided analysis", Eur Radiol, 29, pp.6309~6318 (2019)
- Lee KM, "Effects of anatomical characteristics as factors in abdominal aortic aneurysm rupture: CT aortography analysis", Medicine (Baltimore), 96, pp.e7236~ (2017)
- Bor AS, "Clinical, radiological, and flow-related risk factors for growth of untreated, unruptured intracranial aneurysms", Stroke, 46, pp.42~48 (2015)
- de Rooij NK, "Configuration of the circle of Willis, direction of flow, and shape of the aneurysm as risk factors for rupture of intracranial aneurysms", J Neurol, 256, pp.45~50 (2009)
- Jung KH, "New pathophysiological considerations on cerebral aneurysms", Neurointervention, 13, pp.73~83 (2018)
- Duan Z, "Morphological parameters and anatomical locations associated with rupture status of small intracranial aneurysms", Sci Rep, 8, pp.6440~ (2018)
- Skodvin TØ, "Prerupture intracranial aneurysm morphology in predicting risk of rupture : a matched case-control study", Neurosurgery, 84, pp.132~140 (2019)