Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development
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VASCULAR-INTERVENTIONAL
Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development Kornelia M. Kliś 1,2,3 & Roger M. Krzyżewski 3,4 & Borys M. Kwinta 3,4 & Bartłomiej Łasocha 5 & Paweł Brzegowy 5 & Krzysztof Stachura 4 & Tadeusz J. Popiela 5 & Radosław Borek 6 & Jerzy Gąsowski 3,7 Received: 29 October 2019 / Revised: 23 March 2020 / Accepted: 23 April 2020 # The Author(s) 2020
Abstract Objectives We analysed tortuosity of basilar artery (BA) to determine its relationship with the presence of aneurysm. Methods We retrospectively analysed 71 patients with BA aneurysms along with 71 age- and risk factors-matched control patients without BA aneurysm. From patients’ medical records, we obtained their history including previous and current diseases and medications. For each patient, we calculated relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD) and inflexion count metrics (ICM). We used t-test and Mann-Whitney U test for continuous variables and χ2 test for dichotomised variables. To find independent predictors of BA aneurysm, we employed logistic regression analysis. Results We found significant positive correlation between age and SOAM (R = 0.195, p = 0.02) and PAD (R = 0.199, p = 0.018). Our study also showed that patients with BA aneurysm had significantly higher SOAM (0.21 ± 0.16 vs. 0.11 ± 0.08; p < 0.01), PAD (0.30 ± 0.19 vs. 0.18 ± 0.11; p < 0.01), TI (0.23 ± 0.23 vs. 0.10 ± 0.16; p < 0.01) and ICM (0.20 ± 0.16 vs. 0.15 ± 0.11; p = 0.045). In multivariate logistic regression analysis, after adjustment for all possible confounders, SOAM (OR = 1.086; 95% CI 1.046–1.136; p < 0.01) and TI (OR = 1.004; 95%C: 1.002–1.006; p < 0.01) remained independently associated with higher risk of BA aneurysm. Conclusions Increased tortuosity of BA is associated with higher risk of its aneurysm development. Key Points • Basilar artery sum of angle metrics and product of angle distance are correlated with age. • Basilar artery tortuosity is independently associated with higher risk of its aneurysm development. • Basilar artery tortuosity is positively correlated with its diameter and bifurcation angle. Keywords Angiography . Basilar artery . Intracranial aneurysm
Abbreviations ACA Anterior cerebral artery BA Basilar artery DSA Digital subtraction angiography ICA Internal carotid artery
ICM MCA PAD PCA RL
* Roger M. Krzyżewski [email protected]
4
Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Macieja Jakubowskiego 2 Street, 30-688 Kraków, Poland
5
Department of Radiology, Jagiellonian University Medical College, University Hospital, Kraków, Poland
6
1st Department of Internal Medicine with Cardiology Subdivision, Blessed Marta Wiecka District Hospital, Bochnia, Poland
7
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
1
Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
2
Faculty of Compu
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