TY - JOUR
T1 - Aneurysm volume-to-ostium area ratio
T2 - A parameter useful for discriminating the rupture status of intracranial aneurysms
AU - Yasuda, Ryuta
AU - Strother, Charles M.
AU - Taki, Waro
AU - Shinki, Kazuhiko
AU - Royalty, Kevin
AU - Pulfer, Kari
AU - Karmonik, Christof
PY - 2011/2/1
Y1 - 2011/2/1
N2 - BACKGROUND: Slow or stagnant flow is a hemodynamic feature that has been linked to the risk of aneurysm rupture. OBJECTIVE: To assess the potential value of the ratio of the volume of an aneurysm to the area of its ostium (VOR) as an indicator of intra-aneurysmal slow flow and, thus, in turn, the risk of rupture. METHODS: Using a sample defined from internal databases, a retrospective analysis of aneurysm size, aspect ratio (AR), and VOR was performed on a series of 155 consecutive aneurysms having undergone 3-dimensional digital subtraction angiography as a part of their evaluation. Measurements were obtained from 3-dimensional digital subtraction angiography studies using commercial software. Aneurysm size, AR, and VOR were correlated with rupture status (ruptured or unruptured). A multiple logistic regression model that best correlated with rupture status was generated to evaluate which of these parameters was the most useful to discriminate rupture status. This model was validated using an independent database of 62 consecutive aneurysms acquired outside the retrospective study interval. RESULTS: VOR showed better discrimination for rupture status than did size and AR. The best logistic regression model, which included VOR rather than size or AR, determined rupture status correctly in 80.6% of subjects. The reproducibility calculating AR and VOR was excellent. CONCLUSION: Determination of VOR was easily done and reproducible using widely available commercial equipment. It may be a more robust parameter to discriminate rupture status than AR.
AB - BACKGROUND: Slow or stagnant flow is a hemodynamic feature that has been linked to the risk of aneurysm rupture. OBJECTIVE: To assess the potential value of the ratio of the volume of an aneurysm to the area of its ostium (VOR) as an indicator of intra-aneurysmal slow flow and, thus, in turn, the risk of rupture. METHODS: Using a sample defined from internal databases, a retrospective analysis of aneurysm size, aspect ratio (AR), and VOR was performed on a series of 155 consecutive aneurysms having undergone 3-dimensional digital subtraction angiography as a part of their evaluation. Measurements were obtained from 3-dimensional digital subtraction angiography studies using commercial software. Aneurysm size, AR, and VOR were correlated with rupture status (ruptured or unruptured). A multiple logistic regression model that best correlated with rupture status was generated to evaluate which of these parameters was the most useful to discriminate rupture status. This model was validated using an independent database of 62 consecutive aneurysms acquired outside the retrospective study interval. RESULTS: VOR showed better discrimination for rupture status than did size and AR. The best logistic regression model, which included VOR rather than size or AR, determined rupture status correctly in 80.6% of subjects. The reproducibility calculating AR and VOR was excellent. CONCLUSION: Determination of VOR was easily done and reproducible using widely available commercial equipment. It may be a more robust parameter to discriminate rupture status than AR.
KW - Aneurysm
KW - Aspect ratio
KW - Hemodynamics
KW - Rupture
KW - Volume-to-ostium ratio
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U2 - 10.1227/NEU.0b013e3182010ed0
DO - 10.1227/NEU.0b013e3182010ed0
M3 - Article
C2 - 21135739
AN - SCOPUS:79951670707
VL - 68
SP - 310
EP - 317
JO - Neurosurgery.
JF - Neurosurgery.
SN - 0148-396X
IS - 2
ER -