1. Influence of Carotid Siphon Anatomy on Brain Aneurysm Presentation
- Author
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Pierot, Laurent, Gauvrit, Jean-Yves, Costalat, Vincent, Piotin, Michel, Herbreteau, Denis, Gallas, Sophie, Anxionnat, René, Desal, Hubert, Waihrich, E., Clavel, P., Mendes, G.A.C., Iosif, C., Moraes Kessler, I., Mounayer, Charbel, Université de Reims Champagne-Ardenne (URCA), Service de radiologie et imagerie médicale [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Guy de Chaulliac, Service des Urgences cérébrovasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de neuroradiologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Hôpital Henri Mondor, Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Ministère de l'agriculture et de la pêche, Service de Neurologie [CHU Limoges], CHU Limoges, Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], CHU Pontchaillou [Rennes], Service des Urgences Cérébro-Vasculaires [CHU Pitié-Salpétriêre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)
- Subjects
Brain aneurysm ,Adult ,Male ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Hemodynamics ,Aneurysm, Ruptured ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Risk Factors ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Interventional neuroradiology ,ComputingMilieux_MISCELLANEOUS ,Aged ,Siphon (insect anatomy) ,medicine.diagnostic_test ,Interventional ,business.industry ,Angiography, Digital Subtraction ,Intracranial Aneurysm ,Blood flow ,Anatomy ,Middle Aged ,medicine.disease ,Angiography ,cardiovascular system ,Female ,Neurology (clinical) ,Radiology ,Presentation (obstetrics) ,business ,030217 neurology & neurosurgery ,Carotid Artery, Internal - Abstract
BACKGROUND AND PURPOSE: Intracranial aneurysm is a devastating disease of complex etiology that is not fully understood. The purpose of this study was to assess the implications of carotid siphon anatomy for the formation and development of intracranial aneurysms. MATERIALS AND METHODS: Between January 2007 and May 2015, lateral view digital subtraction angiographic images of 692 consecutive patients with intracranial aneurysms treated in our department of interventional neuroradiology were reviewed and had their angles measured. Data on the location, presentation, and size of the lesions were collected and evaluated by multivariate analysis in relation to the measured angles. RESULTS: Of 692 aneurysms, 225 (32.51%) ruptured and 467 (67.49%) unruptured, 218 (31.50%) were in the carotid siphon and 474 (68.50%) were distal to the siphon, and the mean aneurysm size was 7.99 ± 6.95 mm. Multivariate analysis showed an association between angles of >15.40° and rupture (P = .005), postsiphon location (P = .034), and aneurysm size of >1.001 mm (P = .015). Multivariate analysis also showed that every 1-year increase in patient age produced an increase of 1.002 mm in aneurysm size (P = .015). CONCLUSIONS: There was a significant independent direct relation of greater anterior knee angle with intracranial aneurysms located distal to the carotid siphon, larger aneurysms, and greater risk of rupture. These findings may be associated with the hemodynamic interactions of blood flow and the curvature of the carotid siphon.
- Published
- 2017