gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Morphological characteristics of lobulated intracranial aneurysms as seen on two- and three-dimensional digital subtraction angiography

Angiographische Charakteristiken von gelappten intrakraniellen Aneurysmen

Meeting Abstract

  • presenting/speaker Lukas Goertz - Uniklinik Köln, Köln, Deutschland
  • Christina Hamisch - Uniklinik Köln, Köln, Deutschland
  • Christoph Kabbasch - Uniklinik Köln, Köln, Deutschland
  • Jan Borggrefe - Uniklinik Köln, Köln, Deutschland
  • Roland Goldbrunner - Uniklinik Köln, Köln, Deutschland
  • Boris Krischek - Uniklinik Köln, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV112

doi: 10.3205/19dgnc118, urn:nbn:de:0183-19dgnc1180

Published: May 8, 2019

© 2019 Goertz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Evidence suggests that lobulated aneurysms have a higher risk of rupture than single-sac aneurysms. However, lobulated aneurysms have not yet been studied in detail in the available literature. The objective of the current study was to determine the angiographic characteristics of lobulated aneurysms and compare them to regular, single-sac aneurysms.

Methods: This is a retrospective, single-center analysis of consecutive patients with unruptured saccular intracranial aneurysms that underwent digital subtraction angiography between 2010 and 2017. We determined the following parameters based on two- and three-dimensional digital subtraction angiography: aneurysm location, aneurysm size, neck width, dome-to-neck (D/N) ratio, aspect ratio, parent artery diameter, size ratio, aneurysm inflow angle, aneurysm inclination angle and aneurysm shape. According to their shape, the aneurysms were classified as single-sac aneurysms with regular margin, single-sac aneurysms with irregular margin, aneurysms with daughter sacs, and lobulated aneurysms. In the current study, we compared morphological features of regular aneurysms and lobulated aneurysms by means of univariate and bivariate logistic regression analysis.

Results: The study population consisted of 143 patients harbouring 82 lobulated and 121 regular aneurysms. In the univariate analysis, lobulated aneurysms were significantly associated with anterior communicating artery location (26.8% vs. 2.5%; p<0.01), bifurcation location (69.5% vs. 27.3%; p<0.01), aneurysm size (8.1±3.2 mm vs. 4.9±3.0 mm; p<0.01), inflow angle (144.6±26.1° vs. 113.6±26.6°; p<0.01) and aneurysm treatment (86.6% vs. 60.3%; p<0.01). Bifurcation location (OR: 3.0, 95% CI: 1.2–7.5; p=0.02), aneurysm size >5.5 mm (OR: 5.4, 95% CI: 1.7–17.8; p=0.01) and inflow angle >125° (OR: 2.8, 95% CI: 1.1–7.2; p=0.03) remained as independent factors related to lobulated aneurysm shape in the multivariate analysis.

Conclusion: Bifurcation location and a straighter aneurysm inflow angle are independent factors related to aneurysm growth and formation of lobulated aneurysms, and may therefore lead to an increased risk of rupture.