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Increased Concentrations of Atherogenic Proteins in Aneurysm Sac Are Associated with Wall Enhancement of Unruptured Intracranial Aneurysm

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Abstract

Current MR-vessel wall imaging (VWI) of unruptured intracranial aneurysms (UIAs) permits the visualization of wall structures. Aneurysm wall enhancement (AWE) was associated with atherosclerotic remodeling of the aneurysm wall accompanied by infiltration of inflammatory cells, potentially contributing to rupture. This study sought to investigate whether the luminal concentrations of atherosclerotic proteins in the aneurysm sac were associated with increased wall enhancement of UIAs in VWI. Subjects undergoing endovascular treatment for UIAs were prospectively recruited. All subjects underwent evaluation using 3 T-MRI including pre/post contrast VWI of the UIAs. Blood samples were collected from the aneurysm sac and the parent artery during endovascular procedures. The presence of AWE was correlated with the delta difference in concentration between the aneurysm sac and the parent artery for each atherosclerotic protein. A total of consecutive 45 patients with 50 UIAs were enrolled. The delta differences of anti-oxidized low-density lipoprotein (LDL) antibody, small dense LDL, and lipoprotein(a) [Lp(a)] were significantly higher in UIAs with AWE compared with those without AWE (767.6 ± 1957.1 versus − 442.4 ± 1676.3 mIU/mL, p = 0.02, 114.8 ± 397.7 versus − 518.5 ± 1344.4 μg/mL, p = 0.04, and − 5.6 ± 11.3 versus − 28.7 ± 38.5 μg/mL, p = 0.01, respectively). In multivariate logistic regression analysis, the delta Lp(a) was significantly associated with AWE (p = 0.04). Increased concentrations of atherogenic proteins in the aneurysm sac were significantly associated with wall enhancement of UIAs. Future studies examining the effect of medications for atherosclerosis on the atherogenic proteins within the aneurysm sac and hence the wall enhancement are warranted.

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Fig. 1

Data Availability

The data and analytic methods of this study are available from the corresponding author upon reasonable request.

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Funding

This work was partially supported by Nakatani Foundation to Dr Ishii.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Daizo Ishii, Alexander Choi, Anthony Piscopo, Zain Mehdi, Mario Zanaty, Yongjun Lu & David M. Hasan

  2. Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Ashrita Raghuram & Edgar A. Samaniego

Authors
  1. Daizo Ishii
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  2. Alexander Choi
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  3. Anthony Piscopo
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  4. Zain Mehdi
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  5. Ashrita Raghuram
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  6. Mario Zanaty
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  7. Yongjun Lu
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  8. Edgar A. Samaniego
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  9. David M. Hasan
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Contributions

DI designed the study, wrote the manuscript, researched the data, and contributed to the discussion. AC researched the data, contributed to the discussion, and edited the manuscript. AP, ZM, AR, MZ, and EAS contributed to the discussion,and edited the manuscript. YL researched the data and edited the manuscript. DMH designed the study, reviewed/edited the manuscript, and contributed to the discussion.

Corresponding author

Correspondence to Daizo Ishii.

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Ethics Approval

This study was approved by the University of Iowa institutional review board.

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Informed consent was obtained from all individual participants included in this study.

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The authors declare no competing interests.

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Ishii, D., Choi, A., Piscopo, A. et al. Increased Concentrations of Atherogenic Proteins in Aneurysm Sac Are Associated with Wall Enhancement of Unruptured Intracranial Aneurysm. Transl. Stroke Res. 13, 577–582 (2022). https://doi.org/10.1007/s12975-021-00975-5

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  • DOI: https://doi.org/10.1007/s12975-021-00975-5

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