gms | German Medical Science

Objective: Previous studies based on theoretical flow dynamic measurements reported a potential correlation of the size of related parent vessels to the ruptured aneurysm itself. The goal of the present study was to analyze this correlation in a large patient cohort.

Methods: Retrospectively, patients were included in the analysis who met the following criteria: 1) Aneurysmal subarachnoid hemorrhage, and 2) Accurate 3-dimensional (3D) digital subtraction angiography. Aneurysm aspect ratios (maximum diameter and neck size) as well as the exact parent vessel calibers were measured by two independent investigators (NE, ÜK). Linear regression models were calculated using SPSS.

Results: 220 patients were included in the present study. Median aneurysm size was 6.59 mm, with 74.5% of the aneurysms smaller than 7mm. The majority of the aneurysms were localized at the anterior communicating artery (ACOM: 36.4%), middle cerebral artery (MCA: 20.9%), posterior communicating artery (PCOM: 14.1%) and basilar artery (BA: 10.9%). Despite significant differences between the mean aneurysm sizes among the ACOM, MCA and BA (p < 0.001), there was no correlation between the mean aneurysm size and parent vessel diameter for ACOM, MCA and BA (R², linear = 0.036, 0.003, 0.222, respectively). However, there was a moderate correlation between aneurysm diameter and neck width (R², linear = 0.23).

Conclusions: The data in the present analysis, derived from a large clinical cohort, do not support the assumption of a significant relation between the size of related parent vessels to the ruptured aneurysm itself. This underlines the growing evidence that alternative factors additional to flow dynamics could be responsible for cerebral aneurysm rupture.