title: Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case-control study.
abstract: OBJECTIVE
  We evaluated the correlation between posterior communicating artery (PcomA) aneurysm rupture and morphological and hemodynamic parameters to assess related rupture risk indices.
  
  
  METHODS
  Six patients with PcomA aneurysms that ultimately ruptured (cases) were studied after initially being included in a prospective database including their three-dimensional (3D) imaging before rupture. For each case, four incidental stable unruptured aneurysms (controls) were randomly selected and matched based on clinical factors. The 3D images from all patients were reconstructed to establish the patient-specific model. Six morphologic parameters and three hemodynamic parameters were measured and calculated. A conditional logistic regression analysis was used to assess the individual risk of rupture.
  
  
  RESULTS
  The analysis demonstrated a larger aneurysm size (p=0.001), higher aspect ratio (p=0.018), ellipticity index (p<0.001), undulation index (p=0.005), percentage of low wall shear stress (WSS) area (LSA%) (p=0.010), and a lower normalized WSS (p=0.005) in the case group. The multivariate conditional logistic regression analysis demonstrated that only normalized WSS was significantly associated with the rupture of PcomA aneurysms (OR 0.151; 95% CI 0.025 to 0.914; p=0.040).
  
  
  CONCLUSIONS
  Hemodynamics and morphology are closely associated with aneurysm rupture, and WSS may be a more reliable parameter characterizing the rupture status of PcomA aneurysms.
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Guoli
authors.initials: G
authors.lastname: Duan
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Lv
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yin
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jinyu
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D008959:Models, Neurological; D011859:Radiography
keywords: Aneurysm; Angiography; Blood Flow