Effect of Aneurysm and Patient Characteristics on Intracranial Aneurysm Wall Thickness

Article Article scientifique Article Effect of Aneurysm and Patient Characteristics on Intracranial Aneurysm Wall Thickness eng 2021-12-08 2021-12-08 author Acosta Jason Michaël 824638 author Cayron Anne France Judith 816957 author Dupuy Nicolas 817748 author Pelli Graziano 105578 author Foglia Bernard 120721 author Haemmerli Julien 0000-0001-5998-8541 659636 author Allémann Eric 0000-0002-6598-9521 26730 author Bijlenga Philippe Alexandre Pierre 0000-0002-3586-2757 104899 author Kwak Brenda 0000-0003-0015-0044 113350 author Morel Sandrine 0000-0003-1538-3553 654076 775307 10.3389/fcvm.2021.775307 34957259 2297-055X PMC8692777 https://www.frontiersin.org/articles/10.3389/fcvm.2021.775307/full Background: The circle of Willis is a network of arteries allowing blood supply to the brain. Bulging of these arteries leads to formation of intracranial aneurysm (IA). Subarachnoid hemorrhage (SAH) due to IA rupture is among the leading causes of disability in the western world. The formation and rupture of IAs is a complex pathological process not completely understood. In the present study, we have precisely measured aneurysmal wall thickness and its uniformity on histological sections and investigated for associations between IA wall thickness/uniformity and commonly admitted risk factors for IA rupture. Methods: Fifty-five aneurysm domes were obtained at the Geneva University Hospitals during microsurgery after clipping of the IA neck. Samples were embedded in paraffin, sectioned and stained with hematoxylin-eosin to measure IA wall thickness. The mean, minimum, and maximum wall thickness as well as thickness uniformity was measured for each IA. Clinical data related to IA characteristics (ruptured or unruptured, vascular location, maximum dome diameter, neck size, bottleneck factor, aspect and morphology), and patient characteristics [age, smoking, hypertension, sex, ethnicity, previous SAH, positive family history for IA/SAH, presence of multiple IAs and diagnosis of polycystic kidney disease (PKD)] were collected. Results: We found positive correlations between maximum dome diameter or neck size and IA wall thickness and thickness uniformity. PKD patients had thinner IA walls. No associations were found between smoking, hypertension, sex, IA multiplicity, rupture status or vascular location, and IA wall thickness. No correlation was found between patient age and IA wall thickness. The group of IAs with non-uniform wall thickness contained more ruptured IAs, women and patients harboring multiple IAs. Finally, PHASES and ELAPSS scores were positively correlated with higher IA wall heterogeneity. Conclusion: Among our patient and aneurysm characteristics of interest, maximum dome diameter, neck size and PKD were the three factors having the most significant impact on IA wall thickness and thickness uniformity. Moreover, wall thickness heterogeneity was more observed in ruptured IAs, in women and in patients with multiple IAs. Advanced medical imaging allowing in vivo measurement of IA wall thickness would certainly improve personalized management of the disease and patient care. Intracranial aneurysm Subarachnoid hemorrhage Risk factors Wall thickness uniformity Wall thickness Dewey 616.8 Dewey 615 Dewey 616.07 137 Département de pathologie et immunologie 21F 31 Section des sciences pharmaceutiques 17 61 Département des neurosciences cliniques 226 false 397 Connexines et pathologies cardiovasculaires 665 883 Technologie pharmaceutique Frontiers in cardiovascular medicine 8 65b7a8b4-7fb8-4000-86fc-13f6a3c1bed5 Article (Published version) Public Acosta_FCVM_2021.pdf 2962878 application/pdf CC BY-4.0 7f7d7caf-8c34-4b8a-8f49-ca363e1b4ef9 Supplemental data Public Data_Sheet_1.xlsx 76020 application/vnd.openxmlformats-officedocument.spreadsheetml.sheet openAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté des sciences / Section des sciences pharmaceutiques Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques

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Effect of Aneurysm and Patient Characteristics on Intracranial Aneurysm Wall Thickness	Frontiers in cardiovascular medicine			2021	356	222

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Acosta, Jason Michaël