Author:
Shimizu Kampei,Kataoka Hiroharu,Imai Hirohiko,Miyata Takeshi,Okada Akihiro,Sakai Nobuyuki,Chin Masaki,Iwasaki Koichi,Hatano Taketo,Imamura Hirotoshi,Ishibashi Ryota,Goto Masanori,Koyanagi Masaomi,Aoki Tomohiro,Miyamoto Susumu
Abstract
AbstractThe role of the bifurcation angle in progression of saccular intracranial aneurysms (sIAs) has been undetermined. We, therefore, assessed the association of bifurcation angles with aneurysm progression using a bifurcation-type aneurysm model in rats and anterior communicating artery aneurysms in a multicenter case–control study. Aneurysm progression was defined as growth by ≥ 1 mm or rupture during observation, and controls as progression-free for 30 days in rats and ≥ 36 months in humans. In the rat model, baseline bifurcation angles were significantly wider in progressive aneurysms than in stable ones. In the case–control study, 27 and 65 patients were enrolled in the progression and control groups. Inter-observer agreement for the presence or absence of the growth was excellent (κ coefficient, 0.82; 95% CI, 0.61–1.0). Multivariate logistic regression analysis showed that wider baseline bifurcation angles were significantly associated with subsequent progressions. The odds ratio for the progression of the second (145°–179°) or third (180°–274°) tertiles compared to the first tertile (46°–143°) were 5.5 (95% CI, 1.3–35). Besides, the bifurcation angle was positively correlated with the size of aneurysms (Spearman’s rho, 0.39; P = 0.00014). The present study suggests the usefulness of the bifurcation angle for predicting the progression of sIAs.
Funder
Core Research for Evolutional Science and Technology (CREST) on Mechanobiology from the Japan Agency for Medical Research and Development
Grant-in-Aid for Scientific Research from The Ministry of Education, Culture, Sports, Science and Technology
Publisher
Springer Science and Business Media LLC
Cited by
1 articles.
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