Morphological and Hemodynamic Differences Between Ruptured and Unruptured Vertebral Artery Dissecting Aneurysms: A Two-Center Retrospective Study

Purpose The morphological and hemodynamic features of patients with vertebral artery dissecting aneurysms (VADAs) are yet unknown. This study sought to elucidate morphological and hemodynamical features of patients with ruptured and unruptured VADAs. Methods This study recruited 31 patients with unruptured VADAs and 21 patients with ruptured VADAs who were treated at two hospitals. We collected data on their clinical, morphological, and hemodynamic characteristics. After reconstructing a patient-specific model, computational fluid dynamics (CFD) was performed. Binary logistic regression was used to analyze significant parameters and identify independent risk factors. Receiver operating characteristic (ROC) analysis identified cut-off values separating ruptured from unruptured aneurysms for each parameter. Results Three hemodynamic parameters were observed to be significantly different between ruptured and unruptured VADAs: intra-aneurysmal pressure (IAP), wall shear stress (WSS), and normalized pressure (NP). However, no morphological parameters had a significant difference between ruptured and unruptured VADAs. Binary logistic regression analysis revealed that IAP (AUC = 0.9662, 95% CI 1.014–1.068) and WSS (AUC = 0.7873, 95% CI 1.124–16.859) were independently significant variables in the hemodynamics model. Conclusion This study indicated significant hemodynamic differences but no significant morphological difference between ruptured and unruptured VADAs. Hemodynamic parameters of IAP and WSS are important in discriminating VADAs rupture status. These results should be confirmed through future larger studies.