Document Detail


Risk of aneurysm rupture at intracranial arterial bifurcations.
MedLine Citation:
PMID:  20424442     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aneurysms on the posterior circulation, most commonly located at the basilar top, have a higher risk of rupture than aneurysms on the anterior circulation. If hemodynamic shear stress, which has its maximum impact at the distal carina of bifurcations, explains the higher rupture rate of basilar top aneurysms, aneurysms at the top of the carotid artery should have similar rupture rates given their geometrical similarities.
AIM: Our purpose was to compare rupture risks of carotid and basilar artery bifurcation aneurysms.
METHODS: We included studies from Medline and Embase searches and compared proportions of ruptured and unruptured aneurysms at the basilar and carotid bifurcation with the assumption that carotid aneurysms are twice as prevalent based on the presence of 2 carotid and 1 basilar artery bifurcation on the circle of Willis.
RESULTS: Of all unruptured aneurysms, 8.3% were located on the basilar and 6.0% on the carotid bifurcation; 8.0% of all ruptured aneurysms were located on the basilar and 4.3% on the carotid bifurcation. Subsequently the ratios of carotid versus basilar aneurysms were 0.72 for unruptured and 0.55 for ruptured aneurysms, instead of the expected 2.0.
CONCLUSIONS: Aneurysms are less frequently located on the carotid than on the basilar artery bifurcation. The proportion of ruptured carotid aneurysms is smaller than that of unruptured carotid aneurysms, suggesting a lower rupture risk for aneurysms at the carotid artery bifurcation. The anatomical geometry of the bifurcations and concomitant hemodynamic stress are considered an unlikely explanation for the higher risk of posterior circulation aneurysms.
Authors:
Nicolien M van der Kolk; Ale Algra; Gabriël J E Rinkel
Publication Detail:
Type:  Comparative Study; Journal Article; Review     Date:  2010-04-27
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  30     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-09-14     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  29-35     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Ruptured / etiology*,  pathology,  physiopathology
Basilar Artery* / pathology,  physiopathology
Carotid Arteries* / pathology,  physiopathology
Hemodynamics
Humans
Intracranial Aneurysm / complications*,  pathology,  physiopathology
Risk Assessment
Risk Factors
Subarachnoid Hemorrhage / etiology*,  pathology,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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