Artikel
Vertebral artery aneurysms and associated vascularvariants
Aneurysmen der A.vertebralis und assoziierte vaskuläre Normvarianten
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Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: The aim of this retrospective case-control study is to determine the association of vertebral artery hypoplasia (VAH) and other anatomical variants with saccular vertebral artery posterior inferior cerebellar artery (VA-PICA) aneurysms.
Methods: The prevalence of VAH, vertebral artery (VA) atresia, fetal distribution, VA, and PICA aplasia have been analyzed by CT angiography in 64 patients with VA-PICA aneurysms (43 ruptured and 21 unruptured) and compared to 128 age- and sex-matched controls. VAH is defined by a diameter of ≤ 2 mm at the level of the foramen magnum. Logistic regression is performed to identify independent risk factors for aneurysm formation.
Results: VAH (53% vs. 17%; odds ratio [OR] 4.8; 95% confidence interval [CI] 2.4–9.4; p<0.0001) and VA aplasia (14% vs. 1%; OR 20.8; 95% CI 2.5–168.0; p=0.004) is observed significantly more often in patients with VA-PICA aneurysms than in controls, using univariate analysis. Multivariate analysis identifies VAH (odds ratio, 3.6; 95% CI 1.8–7.3; p<0.0001), as independent strong risk factor for VA-PICA aneurysm formation. VA-PICA aneurysms is detected significantly more often in the dominant VA, contralateral to VAH. Other anatomical variants are not related to aneurysm formation.
Conclusion: VAH and VA aplasia are potential risk factors for VA-PICA aneurysms. Additional research should clarify the pathophysiological association of VAH, VA aplasia, or vascular occlusion with arteriosclerosis and intracranial aneurysm formation.