title: Association Between Vascular Anatomy and Posterior Communicating Artery Aneurysms.
abstract: OBJECTIVE
  Hemodynamic stress, conditioned by the geometry and morphology of the vessel trees, plays an important role in the formation of intracranial aneurysms. The aim of this study was to identify image-based location-specific morphologic parameters that are associated with posterior communicating artery (PCoA) aneurysms.
  
  
  METHODS
  Morphologic parameters obtained from computed tomography angiography of 56 patients with PCoA aneurysms and 23 control patients were evaluated with 3D Slicer, an open-source image analysis software, to generate 3-dimensional models of the aneurysms and surrounding vasculature. Segment lengths, diameters, and vessel-to-vessel angles were examined. To control for genetic and clinical risk factors, the unaffected contralateral side of patients with unilateral PCoA aneurysms was used as a control group for internal carotid artery (ICA)-related parameters. A separate control group with visible PCoAs and aneurysms elsewhere was used as a control group for PCoA-related parameters.
  
  
  RESULTS
  Internal carotid artery-related parameters were not statistically different between the PCoA aneurysm and control groups. Univariate and multivariate subgroup analysis for patients with visualized PCoAs demonstrated that a larger PCoA diameter was significantly associated with the presence of a PCoA aneurysm (odds ratio = 12.1, 95% confidence interval = 1.3-17.1, P = 0.04) after adjusting for other morphologic parameters.
  
  
  CONCLUSIONS
  Larger PCoA diameters are associated with the presence of PCoA aneurysms. These parameters may provide objective metrics to assess aneurysm formation and growth risk stratification in high-risk patients.
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Anil
authors.initials: A
authors.lastname: Can
authors.affiliation: Department of Neurosurgery, Stanford University, Palo Alto, California, USA.
authors.forename: Allen L
authors.initials: AL
authors.lastname: Ho
authors.affiliation: Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Emmer
authors.affiliation: Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ruben
authors.initials: R
authors.lastname: Dammers
authors.affiliation: Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Clemens M F
authors.initials: CM
authors.lastname: Dirven
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: rdu@partners.org.
authors.forename: Rose
authors.initials: R
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002343:Carotid Artery, Internal / Q000473:pathology; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007091:Image Processing, Computer-Assisted; D002532:Intracranial Aneurysm / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020769:Posterior Cerebral Artery / Q000033:anatomy & histology* / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
keywords: Fluid dynamics; Intracranial aneurysm; Morphology; Posterior communicating artery