The Analysis For Risk Factors Of Posterior Communicating Artery Aneurysm Rupture

ObjectivePosterior communicating artery (PComA) aneurysm is one of the most common intracranial aneurysms and more likely to rupture than others. Most of the previous studies covered different parts of intracranial aneurysms, so they contained several inevitable interferences. This paper aimed to identify morphological and clinical characteristics predisposing to PComA aneurysm rupture.MethodsThe author retrospectively reviewed185patients with PComA aneurysms met certain inclusion criteria managed at his facility from Jan2011to Dec2013. The study divided patients into groups of those with aneurysmal rupture (n=138) and without aneurysmal rupture (n=47) and compared morphological and clinical characteristics. Morphological characteristics were all evaluated by3D-DSA and included size of the aneurysm, dome-to-neck ratio (AR), direction of the aneurysmal dome around PComA and aneurysm bleb formation.ResultsThe rupture rates of PComA aneurysm in the two group have no significant differences in the single-factor analysis in gender(x2=0.207,p=0.649), age<60years(x2=0.179,p=0.672), smoking history(x2=0.298,p=0.585), alcohol intaking history(x2=0.118,p=0.731), aneurysmal subarachnoid hemorrhage(aSAH) family history(x2=1.976,p=0.161) a nd size of aneurysm≥7mm(x2=2.467,p=0.116), but have significant di fferences in the single-factor analysis in hypertension(x2=23.013,p=0.000), AR≥1.5(x2=8.492,p=0.048), the direction of aneurysmal dome (X2=15.057,p=0.020) and aneurysm bleb(x2=18.952, p=0.000); there a re significant differences in mean AR(Z=4.48,p=0.000) between the ruptured group and the not; the rupture rates in male between the s moking and not have significant differences(x2=3.90,p=0.048). Through multiple logistic regression analysis, hypertension(OR=13.240,p=0.000), aneurysm bleb(OR=12.933,p=0.001), age<60yrs(OR=3.766,p=0.010), AR≥1.5(OR=4.997,p=0.001) and posterior-inferior-la-teral direction of the PComA aneurysm (OR=7.584,p=0.038) are associated with PComA aneurysm rupture.ConclusionsThe results demonstrated that hypertension, aneurysm bleb, a ge<60yrs, AR≥1.5and posterior-inferior-lateral projection of PComA aneurysmal dome might be the risk factors for PComA ane urysms rupture.