Objective: The conflicting findings of previous morphological studies on intracranial aneurysm rupture may be caused by the different locations of aneurysms. We aimed to determine the independent risk factors of aneur...Objective: The conflicting findings of previous morphological studies on intracranial aneurysm rupture may be caused by the different locations of aneurysms. We aimed to determine the independent risk factors of aneurysm rupture by focusing on only posterior communicating artery(Pcom A) aneurysms. Methods: In 89 PcomA aneurysms(58 ruptured, 31 unruptured), clinical and morphological characteristics were compared between the ruptured and unruptured groups. Multivariate logistic regression analysis was performed to determine the independent predictors for the rupture status of PcomA aneurysms. Results: In univariate analyses, the aneurysm dome size, aspect ratio, size ratio,dome‐to‐neck ratio, and inflow angle were significant parameters. With multivariate analyses, only the aneurysm dome size and inflow angle were significantly associated with the rupture status of PcomA aneurysms. Conclusions: Morphology was related with rupture of PcomA aneurysms. The aneurysm dome size and inflow angle were found to be the independent parameters characterizing the rupture status of PcomA aneurysms.展开更多
Background:Endovascular coiling for wide-neck aneurysms with a branch arising from the aneurysmal sac is challenging and sometimes considered impossible.This study aims to present our experience in treating wide-neck ...Background:Endovascular coiling for wide-neck aneurysms with a branch arising from the aneurysmal sac is challenging and sometimes considered impossible.This study aims to present our experience in treating wide-neck internal carotid artery(ICA)aneurysms with a posterior communicating artery(PComA)arising from the sac using a strategy of stenting the ICA and intentional compartmentalization to preserve the flow in the PComA.Methods:Eight consecutive cases of wide-neck ICA aneurysms with a fetal-type PComA arising from the aneurysmal sac were embolized from January 2015 to June 2018 at the First Affiliated Hospital,College of Medicine,Zhejiang University.Demographics,angiographic technique,procedural complications and clinical outcomes were reviewed.Results:There were 2 men and 6 women ranging from 56 to 81 years of age.Of the 8 cases,3 were ruptured and 5 were unruptured aneurysms.Stents were successfully deployed in all 8 cases.Near-complete occlusion was achieved in 3 cases(37.5%),neck remnant in 4(50%)and sac remnant in one(12.5%)of the cases.One case suffered transient ischemic attack after procedure completion.The clinical outcome was favorable in all 8 cases(modified Rankin scale 0-1).No rebleeding occurred during clinical follow-up.Conclusion:Stent-assisted compartmentalized embolization is feasible and safe in the treatment of wide-neck ICA aneurysm with a PComA arising from the sac.展开更多
AIM:To explore the risk factors of oculomotor nerve palsy(ONP)in patients with intracranial aneurysm(IA)and develop a nomogram model for predicting ONP of IA patients.METHODS:A total of 329 IA patients were included.L...AIM:To explore the risk factors of oculomotor nerve palsy(ONP)in patients with intracranial aneurysm(IA)and develop a nomogram model for predicting ONP of IA patients.METHODS:A total of 329 IA patients were included.Logistic regression analysis was applied to identify independent factors,which were then integrated into the nomogram model.The performance of the nomogram model was evaluated by calibration cur ve,receiver operating curve(ROC),and decision curve analysis.RESULTS:Univariate and multivariate logistic regression analysis indicated posterior communicating artery(PCo A)aneur ysm[hazard ratio(HR)=17.13,P<0.001]and aneurysm diameter(HR=1.31,P<0.001)were independent risk factors of ONP in IA patients.Based on the results of logistic regression analysis,a nomogram model for predicting the ONP in IA patients was constructed.The calibration curve indicated the nomogram had a good agreement between the predictions and observations.The nomogram showed a high predictive accuracy and discriminative ability with an area under the curve(AUC)of 0.863.The decision curve analysis showed that the nomogram was powerful in the clinical decision.PCo A aneurysm(HR=3.38,P=0.015)was identified to be the only independent risk factor for ONP severity.CONCLUSION:PCo A aneurysm and aneurysm diameter are independent risk factors of ONP in IA patients.The nomogram established is performed reliably and accurately for predicting ONP.PCo A aneurysm is the only independent risk factor for ONP severity.展开更多
基金supported by the Key Project of Shanghai Science and Technology Committee (No. 13411950300)the National Natural Science Foundation of China (No. 81301004)+1 种基金the Key Project of Shanghai Municipal Health Bureau (No. 2013ZYJB007)the 1255 Project of Changhai Hospital (No. CH125550400)
文摘Objective: The conflicting findings of previous morphological studies on intracranial aneurysm rupture may be caused by the different locations of aneurysms. We aimed to determine the independent risk factors of aneurysm rupture by focusing on only posterior communicating artery(Pcom A) aneurysms. Methods: In 89 PcomA aneurysms(58 ruptured, 31 unruptured), clinical and morphological characteristics were compared between the ruptured and unruptured groups. Multivariate logistic regression analysis was performed to determine the independent predictors for the rupture status of PcomA aneurysms. Results: In univariate analyses, the aneurysm dome size, aspect ratio, size ratio,dome‐to‐neck ratio, and inflow angle were significant parameters. With multivariate analyses, only the aneurysm dome size and inflow angle were significantly associated with the rupture status of PcomA aneurysms. Conclusions: Morphology was related with rupture of PcomA aneurysms. The aneurysm dome size and inflow angle were found to be the independent parameters characterizing the rupture status of PcomA aneurysms.
基金supported by the grant from the Zhejiang Province Scientific Fund(LY12F02035).
文摘Background:Endovascular coiling for wide-neck aneurysms with a branch arising from the aneurysmal sac is challenging and sometimes considered impossible.This study aims to present our experience in treating wide-neck internal carotid artery(ICA)aneurysms with a posterior communicating artery(PComA)arising from the sac using a strategy of stenting the ICA and intentional compartmentalization to preserve the flow in the PComA.Methods:Eight consecutive cases of wide-neck ICA aneurysms with a fetal-type PComA arising from the aneurysmal sac were embolized from January 2015 to June 2018 at the First Affiliated Hospital,College of Medicine,Zhejiang University.Demographics,angiographic technique,procedural complications and clinical outcomes were reviewed.Results:There were 2 men and 6 women ranging from 56 to 81 years of age.Of the 8 cases,3 were ruptured and 5 were unruptured aneurysms.Stents were successfully deployed in all 8 cases.Near-complete occlusion was achieved in 3 cases(37.5%),neck remnant in 4(50%)and sac remnant in one(12.5%)of the cases.One case suffered transient ischemic attack after procedure completion.The clinical outcome was favorable in all 8 cases(modified Rankin scale 0-1).No rebleeding occurred during clinical follow-up.Conclusion:Stent-assisted compartmentalized embolization is feasible and safe in the treatment of wide-neck ICA aneurysm with a PComA arising from the sac.
基金Supported by National Natural Science Foundation of China(No.81970822)。
文摘AIM:To explore the risk factors of oculomotor nerve palsy(ONP)in patients with intracranial aneurysm(IA)and develop a nomogram model for predicting ONP of IA patients.METHODS:A total of 329 IA patients were included.Logistic regression analysis was applied to identify independent factors,which were then integrated into the nomogram model.The performance of the nomogram model was evaluated by calibration cur ve,receiver operating curve(ROC),and decision curve analysis.RESULTS:Univariate and multivariate logistic regression analysis indicated posterior communicating artery(PCo A)aneur ysm[hazard ratio(HR)=17.13,P<0.001]and aneurysm diameter(HR=1.31,P<0.001)were independent risk factors of ONP in IA patients.Based on the results of logistic regression analysis,a nomogram model for predicting the ONP in IA patients was constructed.The calibration curve indicated the nomogram had a good agreement between the predictions and observations.The nomogram showed a high predictive accuracy and discriminative ability with an area under the curve(AUC)of 0.863.The decision curve analysis showed that the nomogram was powerful in the clinical decision.PCo A aneurysm(HR=3.38,P=0.015)was identified to be the only independent risk factor for ONP severity.CONCLUSION:PCo A aneurysm and aneurysm diameter are independent risk factors of ONP in IA patients.The nomogram established is performed reliably and accurately for predicting ONP.PCo A aneurysm is the only independent risk factor for ONP severity.
