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Association between flow patterns of the posterior cerebral arterial circle and basilar-tip aneurysms

  • Anatomic Variations
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Abstract

Purpose

The Cerebral arterial circle presents multiple individual anatomical configurations which are of the highest importance regarding the pathological processes for intracranial aneurysms development. Previous studies highlighted the importance of geometry and especially arterial bifurcations leading to aneurysms development. The primary objective of this study was to determine whether a flow pattern asymmetry of the P1 segments of the posterior cerebral arteries was associated with a higher risk of basilar tip aneurysm.

Material and methods

Two different populations were retrospectively reviewed. The first population, without aneurysm, for which TOF MRI sequences were reviewed. The second population with patients harboring basilar tip aneurysms for whom cerebral angiograms were reviewed. We retrospectively analyzed the flow contribution and symmetry of the two right and left P1 segments of the posterior cerebral arteries and the two posterior communicating arteries (Pcomm). We analyzed the association and risk factors for basilar tip aneurysm.

Results

The anatomical and flow configurations of P1 and Pcomm have been reviewed in 467 patients without aneurysms and 35 patients with aneurysms. We identified a significant association between the flow pattern asymmetry of the P1 segments and the presence of a basilar tip aneurysm (OR = 2.12; IC95% = [1.01–4.36]; p = 0.04). We also confirmed that the male gender was protective against aneurysm (OR = 0.45; IC95% = [0.194–0.961]; p = 0.04).

Conclusion

Non-modal basilar tip bifurcation and flow asymmetry of P1 segments are associated with an increased risk of basilar tip aneurysm. These findings highlight the importance of analyzing MRI-TOF of the posterior configuration of the Cerebral arterial circle to potentially refine the aneurysms risk prediction.

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Datasets can be available upon request to the corresponding author.

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Acknowledgements

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Author notes

  1. Pierre Lapraz and Quentin Pinsard are co first-authors.

Authors and Affiliations

  1. Department of Radiology, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France

    Romain Coudert & Aymeric Rouchaud

  2. Department of Human Anatomy, Laboratoire d’Anatomie, Faculty of Medicine, University of Limoges, 2, rue du Docteur Marcland, 87025, Limoges, France

    Pierre Lapraz & Quentin Pinsard

  3. UMR 7252, University of Limoges, XLIM CNRS, 87000, Limoges, France

    Aymeric Rouchaud

  4. Department of Interventional Neuroradiology-NEURI Brain Vascular Center, Bicêtre Hospital, Le Kremlin-Bicêtre, France

    Jonathan Cortese

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  1. Pierre Lapraz
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Contributions

PL: contributed to conception and design of the study, contributed to data collection and analysis, drafting the manuscript, contributed to revising the manuscript for important intellectual content. QP: contributed to conception and design of the study, contributed to data collection and analysis, drafting the manuscript, contributed to revising the manuscript for important intellectual content. RC: contributed to data collection and analysis, drafting the manuscript. JC: contributed to data collection and analysis, drafting the manuscript. AR: contributed to conception and design of the study, contributed to data collection and analysis, drafting the manuscript, contributed to revising the manuscript for important intellectual content. All authors approved the final version to be published.

Corresponding author

Correspondence to Aymeric Rouchaud.

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Ethical approval

As for all non-interventional retrospective studies of de-identified data in France, written informed consent was waived, but the patients or their proxies were informed that they could oppose the use of their de-identified health-related data for the purpose of research.

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Lapraz, P., Pinsard, Q., Coudert, R. et al. Association between flow patterns of the posterior cerebral arterial circle and basilar-tip aneurysms. Surg Radiol Anat 45, 505–511 (2023). https://doi.org/10.1007/s00276-023-03121-y

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  • DOI: https://doi.org/10.1007/s00276-023-03121-y

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