Bum Joon Kim1, Sung Ho Lee2, Byung Duk Kwun2, Hyun Goo Kang3, Keun-Sik Hong4, Dong-Wha Kang5, Jong S Kim5, Sun U Kwon6. 1. Department of Neurology, Kyung Hee University Hospital, Seoul, Korea. 2. Department of Neurosurgery, Kyung Hee University Hospital, Seoul, Korea. 3. Department of Neurology, Chosun University, Gwang-ju, Korea. 4. Department of Neurology, Ilsan Paik Hospital, Inje University, Ilsan, Korea. 5. Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Korea. 6. Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Korea. Electronic address: sukwon@amc.seoul.kr.
Abstract
BACKGROUND: Although intracranial aneurysms (IAs) are focal bulges of arterial walls, an uncharacterized predisposing factor that affects cerebral arteries may increase tortuosity of intracranial arteries in patients with IAs. METHODS: Subjects who underwent routine health examinations and magnetic resonance angiography at a university hospital health promotion center were enrolled. Age- and sex-matched control subjects were selected from among individuals who did not have IAs. Tortuosity of right and left middle cerebral arteries and basilar artery (BA) was measured. Distant factor [(arc/chord ratio × 100) - 100] was used to estimate tortuosity. Vascular risk factors and intracranial arterial tortuosities were compared between subjects with IAs and control subjects. Independent factors associated with intracranial artery tortuosity were also investigated. RESULTS: Of 18,954 (1.9%) subjects, 367 exhibited IAs. The prevalence of hypertension (P = 0.01) and current smoking (P = 0.01) were higher in subjects with IAs than in control subjects. The BA tortuosity was greater in subjects with IAs compared with control subjects (9.0 ± 8.1 vs. 5.5 ± 7.2; P < 0.001). In addition to hypertension, smoking, and absence of coronary artery disease, BA tortuosity (P < 0.001) was independently associated with presence of IAs. The presence of IA (P < 0.001) and absence of coronary artery disease (P = 0.002) were independently associated with high BA tortuosity. CONCLUSIONS: Patients with IAs exhibit a more tortuous BA. A predisposing factor weakening the cerebrovasculature in patients with IAs may exist and may manifest as high tortuosity of intracranial arteries.
BACKGROUND: Although intracranial aneurysms (IAs) are focal bulges of arterial walls, an uncharacterized predisposing factor that affects cerebral arteries may increase tortuosity of intracranial arteries in patients with IAs. METHODS: Subjects who underwent routine health examinations and magnetic resonance angiography at a university hospital health promotion center were enrolled. Age- and sex-matched control subjects were selected from among individuals who did not have IAs. Tortuosity of right and left middle cerebral arteries and basilar artery (BA) was measured. Distant factor [(arc/chord ratio × 100) - 100] was used to estimate tortuosity. Vascular risk factors and intracranial arterial tortuosities were compared between subjects with IAs and control subjects. Independent factors associated with intracranial artery tortuosity were also investigated. RESULTS: Of 18,954 (1.9%) subjects, 367 exhibited IAs. The prevalence of hypertension (P = 0.01) and current smoking (P = 0.01) were higher in subjects with IAs than in control subjects. The BA tortuosity was greater in subjects with IAs compared with control subjects (9.0 ± 8.1 vs. 5.5 ± 7.2; P < 0.001). In addition to hypertension, smoking, and absence of coronary artery disease, BA tortuosity (P < 0.001) was independently associated with presence of IAs. The presence of IA (P < 0.001) and absence of coronary artery disease (P = 0.002) were independently associated with high BA tortuosity. CONCLUSIONS:Patients with IAs exhibit a more tortuous BA. A predisposing factor weakening the cerebrovasculature in patients with IAs may exist and may manifest as high tortuosity of intracranial arteries.
Authors: L Spinardi; G Vornetti; S De Martino; R Golfieri; L Faccioli; M Pastore Trossello; C Graziano; E Mariucci; A Donti Journal: AJNR Am J Neuroradiol Date: 2020-08-20 Impact factor: 3.825
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