Relationship Between Morphological And Hemodynamic Characteristics And Rupture Risk Of Internal Carotid Ophthalmic Segment Aneurysms

Background Intracranial aneurysm is a common clinical cerebrovascular disease.Most patients without rupture have no obvious symptoms in their daily work and life.A small number of patients may experience head and neck discomfort,but it is not yet possible to determine whether a patient has an intracranial aneurysm(IA)based on these symptoms.Among the many causes of spontaneous subarachnoid hemorrhage(SAH),rupture and bleeding of intracranial aneurysm(IA)accounts for the largest proportion.Once it occurs,its mortality and disability rate are high.The main treatment methods for intracranial aneurysms include craniotomy,aneurysm clipping,and interventional embolization of intracranial aneurysms.Both surgical methods and conservative treatment have certain risks.The choice of surgical methods and timing for intracranial aneurysms has been a hot topic of debate among experts at home and abroad.If the factors related to aneurysm rupture can be found and the risk of rupture of unruptured intracranial aneurysm(UIA)can be assessed to guide the selection of clinical treatment methods,the risk of rupture of unruptured intracranial aneurysm(UIA)patients will be effectively reduced.Objective To investigate the relationship between the morphological and hemodynamic characteristics of internal carotid ophthalmic segment aneurysms and the risk of rupture and its possible mechanisms.Methods A retrospective analysis was conducted of patients with intracranial aneurysms in the Neurosurgical Department II of Yichang Central People’s Hospital from June 2021 to July 2022.These patients were diagnosed as intracranial aneurysms by whole brain angiography,and they were willing to undergo morphological and hemodynamic analysis using Aneu Flow software,an auxiliary diagnostic system for intracranial aneurysms.A total of 50 patients were divided into ruptured and non ruptured groups based on whether the aneurysm had ruptured,The ruptured aneurysms were divided into ocular segment aneurysms and anterior communicating artery aneurysms according to their location.Collect patients’ clinical characteristics(including age,gender,hypertension history,diabetes history,smoking history,drinking history),morphological characteristics(maximum height of aneurysm,vertical height of aneurysm,middle diameter,neck diameter,diameter of carrier artery,inclination angle of aneurysm,angle of aneurysm entry,aneurysm volume,aneurysm surface area)and hemodynamic data(wall shear stress,oscillatory shear factor,relative retention time),The clinical characteristics are mainly obtained by consulting the patient’s previous medical records.Morphological data and hemodynamic data are obtained by copying the patient’s CTA,MRA,or DSA data into Aneu Flow software for measurement and simulation.After that,all data are statistically analyzed using SPSS.Results(1)There were 32 ocular aneurysms in total,including 15 ruptured aneurysms(46.88%)and 17 unruptured aneurysms(53.12%).In terms of baseline characteristics,there were no statistically significant differences in age,gender,hypertension history,diabetes history,smoking history,and drinking history between the ruptured and unruptured ocular aneurysms(P>0.05).In terms of morphology,there were statistically significant differences between the ruptured group and the non ruptured group in the middle diameter,neck diameter,aneurysm entry angle,AR value,maximum height,vertical height,SR value,BNR value,volume,and surface area of the aneurysm(P<0.05).In terms of hemodynamics,there were statistically significant differences in WSS and RRT between ruptured and non ruptured aneurysms(P<0.05).(2)There were 33 ruptured intracranial aneurysms,including 15 in the ophthalmic artery segment group(45.45%)and 18 in the anterior communicating group(54.55%).In terms of baseline characteristics,there were no statistically significant differences in age,gender,hypertension history,diabetes history,smoking history,and drinking history(P>0.05).In terms of morphology,there were statistically significant differences between the two groups in the maximum height,middle diameter,neck diameter,and carrier artery diameter of the aneurysm(P.In terms of hemodynamics,there was a statistically significant difference in aneurysm concussion shear factor(OSI)between the two groups of patients(P<0.05),while there was no statistically significant difference in aneurysm wall shear stress(WSS)and relative residence time(RRT)between the two groups of patients(P>0.05).Conclusion(1)In terms of morphology,the larger middle diameter,neck diameter,maximum height,vertical height,aneurysm entry angle,AR value,SR value,BNR value,volume,and surface area of the ophthalmic artery segment aneurysm are risk factors for its rupture.(2)In terms of hemodynamics,lower WSS and higher RRT are risk factors for rupture of ophthalmic artery segment aneurysms.(3)The maximum height,middle diameter,neck diameter,and carrier artery diameter of ruptured ophthalmic artery segment aneurysms were significantly larger than those of ruptured anterior communicating artery segment aneurysms.With the same size,ophthalmic artery segment aneurysms had a lower risk of morphological rupture.