Asymmetry of P1 and vertebral arteries is not related to basilar tip aneurysm development or rupture
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ORIGINAL ARTICLE - VASCULAR NEUROSURGERY - ANEURYSM
Asymmetry of P1 and vertebral arteries is not related to basilar tip aneurysm development or rupture Lan Li 1 & Björn B. Hofmann 2 & Igor Fischer 2 & Daniel M. Donaldson 2 & Adrian Engel 2 & Cihat Karadag 1 & Andreas Wetzel-Yalelis 1 & Guilherme Santos Piedade 2 & Hendrik-Jan Mijderwijk 2 & Richard Bostelmann 2 & Marius G. Kaschner 3 & Sajjad Muhammad 2 & Daniel Hänggi 2 & Jan F. Cornelius 2 & Athanasios K. Petridis 2 Received: 4 July 2020 / Accepted: 22 September 2020 # The Author(s) 2020
Abstract Objective Lately, morphological parameters of the surrounding vasculature aside from aneurysm size, specific for the aneurysm location, e.g., posterior cerebral artery angle for basilar artery tip aneurysms, could be identified to correlate with the risk of rupture. We examined further image-based morphological parameters of the aneurysm surrounding vasculature that could correlate with the growth or the risk of rupture of basilar artery tip aneurysms. Methods Data from 83 patients with basilar tip aneurysms (27 not ruptured; 56 ruptured) and 100 control patients were assessed (50 without aneurysms and 50 with aneurysms of the anterior circle of Willis). Anatomical parameters of the aneurysms were assessed and analyzed, as well as of the surrounding vasculature, namely the asymmetry of P1 and the vertebral arteries. Results Patients with basilar tip aneurysm showed no significant increase in P1 or vertebral artery asymmetry compared with the control patients or patients with aneurysms of the anterior circulation, neither was there a significant difference in asymmetry between cases with ruptured and unruptured aneurysms. Furthermore, we observed no significant correlations between P1 asymmetry and the aneurysm size or number of lobuli in the aneurysms. Conclusion We observed no significant difference in aneurysm size, rupture, or lobulation associated with P1 or vertebral artery (surrounding vasculature) asymmetry. Therefore, the asymmetry of the surrounding vessels does not seem to be a promising morphological parameter for the evaluation of probability of rupture and growth in basilar tip aneurysms in future studies. Keywords Basilar aneurysm . Aneurysm development . Aneurysm rupture . Asymmetry of P1 . Asymmetry of vertebral arteries . Aneurysm lobuli . Subarachnoid hemorrhage
Introduction
Lan Li and Björn B. Hofmann contributed equally to this work. This article is part of the Topical Collection on Vascular Neurosurgery Aneurysm * Björn B. Hofmann [email protected] 1
Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
2
Department of Neurosurgery, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
3
Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
In the treatment of patients with unruptured aneurysms, the physician often faces the decision whether a surgical or interventional therapy or a watchful waitin
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