Geometric variations associated with posterior communicating artery aneurysms.

Area of Science:

• Vascular imaging and analysis
• Biomedical engineering
• Neurosurgery

Background:

• Hemodynamic stress and vascular morphology influence aneurysm formation.
• Posterior communicating artery (PCoA) aneurysms are a significant clinical concern.
• Identifying location-specific risk factors is crucial for PCoA aneurysm development.

Purpose of the Study:

• To identify image-based, location-specific morphological parameters associated with PCoA aneurysms.
• To investigate the relationship between vascular geometry and PCoA aneurysm formation.
• To establish predictive markers for PCoA aneurysm risk assessment.

Main Methods:

• Retrospective analysis of CT angiography/digital subtraction angiography from 187 patients with unilateral PCoA aneurysms.
• Evaluation of 3D morphological parameters, including vessel diameters and angles.
• Utilized contralateral unaffected PCoA as a control, with univariable and multivariable statistical analyses.

Main Results:

• A smaller diameter size ratio (OR 1.45×10⁻⁵) was significantly associated with PCoA aneurysm presence.
• A larger daughter-daughter angle (OR 1.04) was also significantly associated with PCoA aneurysm presence.
• These associations were consistent in subgroup analyses of small aneurysms and unmatched cohorts.

Conclusions:

• Larger daughter-daughter angles and smaller diameter size ratios are key indicators for PCoA aneurysm presence.
• These simple, measurable parameters can enhance risk stratification for PCoA aneurysms.
• The findings support the use of these parameters in clinical risk assessment for high-risk patients.