Study On The Risk Of Rupture Of Posterior Communicating Artery Aneurysm

Objective:To evaluate the rupture risk of un-ruptured posterior communicating artery(P-CoA)aneurysm by comparing the morphological and hemodynamic characteristics of ruptured and un-ruptured P-CoA aneurysms.Materials and methods:From October 2015 to October 2017,76 patients who had three-dimensional angiographic images in affiliated hospital of Hebei university were enrolled in this study,including 43 cases with ruptured P-CoA aneurysms induced subarachnoid hemorrhage,and 33 cases with un-ruptured P-CoA aneurysms.Three-dimensional rotational angiography data were reconstructed for morphological parameters measured,including aneurysm aneurysm angle(AA),height(H),width(D),semi-axis height(S),aneurysm neck(N),up-stream artery diameter(defined as D1)and down-stream artery diameter(defined as D2),as well as H/D,H/S,H/N,D/N,H/D1,H/D2,etc.Hemodynamic parameters,including Surface area of aneurysm,SAR-TAWSS,SAR-OSI,velocity,wall shear stress(WSS),strain rate and vorticity were also compared between ruptured and un-ruptured P-Co A aneurysm.All data were shown as mean ± standard deviation.T test was used between the two groups,difference were considered significantly at P<0.05.Results:1.No significant differences in the H,D,N,D1,D2,H/D,H/N,H/S,H/D2,D/D1,D/D2 N/D1 and N/D2 were observed between ruptured and un-ruptured P-CoA aneurysms(P>0.05).The S,H/D1,D/N and aneurysm angle in ruptured P-CoA aneurysm group were significant larger than those in un-ruptured group(P<0.05),however,the D/S,N/S in ruptured P-CoA aneurysm group were significantly lower than those in un-ruptured group(P<0.05).2.The surface area,SAR-TAWSS and SAR-OSI in ruptured P-CoA aneurysm group were significantly larger than those in un-ruptured group(P<0.05),however,the vorticity,WSS and strain rate on aneurysm wall of ruptured P-CoA aneurysm group were significantly lower than those in un-ruptured group(P<0.05)).No significant differences of flow velocity in aneurysms cavity of two groups were observed(P>0.05).Conclusion:1.The larger aneurysm angle and half axle height were risk factors of P-CoA aneurysm rupture.2.The larger height/D1 and dome diameter/neck width were risk factors of P-Co A aneurysm rupture.The lower dome diameter / half axis height and aneurysm neck / axis height were risk factors of P-CoA aneurysm rupture.3.The larger surface area of aneurysms、SAR-TAWSS and SAR-OSI were the risk factors of P-CoA aneurysm rupture.4.The lower Vorticity,Wall shear stress and Strain rate were the risk factors of P-CoA aneurysm rupture.