Association Between Vertebral Arterial Tortuosity and Aneurysm Growth in Intracranial Vertebral Artery Dissection.

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY Journal of Clinical Neurology Pub Date : 2024-11-01 DOI:10.3988/jcn.2024.0139

Jae Young Park, Sang Hee Ha, Soo Jeong, Jun Young Chang, Dong-Wha Kang, Sun U Kwon, Bum Joon Kim

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Abstract

Background and purpose: An intracranial vertebral artery dissecting aneurysm (iVADA) increases the risk of future subarachnoid hemorrhage, which is a severe complication with high rebleeding rates and poor outcomes. Identifying potential risk factors associated with iVADA growth is crucial for their effective management.

Methods: This observational study was carried out at a single center and included patients who had been diagnosed with iVADA based on neuroimaging findings. We divided the patients into two groups: with and without iVADA growth. Growth was defined as any enlargement of a dilated region or a morphological change in follow-up imaging. We measured the vertebral artery tortuosity index (VTI) in the contralateral vertebral artery (VA), defined as its actual length divided by its straight length. We investigated the factors associated with iVADA growth.

Results: This study included 124 patients. The median follow-up period was 7 months. We observed iVADA growth in 54 patients (43.5%), who were more likely to be current smokers (33.3% vs. 14.3%, p=0.012) and have a higher VTI (1.14±0.11 [mean±standard deviation] vs. 1.06±0.12, p=0.035) compared with those without iVADA growth. A multivariate analysis revealed that the VTI (adjusted odds ratio=28.490, 95% confidence interval=1.025-792.046, p=0.048) was independently associated with iVADA growth.

Conclusions: This study has identified an independent association between VA tortuosity and iVADA growth.

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颅内椎动脉夹层中椎动脉畸形与动脉瘤生长之间的关系

背景和目的：颅内椎动脉夹层动脉瘤（iVADA）会增加未来发生蛛网膜下腔出血的风险，而蛛网膜下腔出血是一种严重的并发症，再出血率高且预后差。识别与 iVADA 生长相关的潜在风险因素对于有效控制这些风险至关重要：这项观察性研究在一个中心进行，研究对象包括根据神经影像学检查结果确诊为 iVADA 的患者。我们将患者分为两组：有 iVADA 增生和无 iVADA 增生。增生的定义是扩张区域的任何扩大或随访成像中的形态变化。我们测量了对侧椎动脉（VA）的椎动脉迂曲指数（VTI），定义为其实际长度除以其直线长度。我们研究了与iVADA增长相关的因素：本研究共纳入 124 例患者。中位随访时间为 7 个月。我们在 54 例患者（43.5%）中观察到 iVADA 增生，与没有 iVADA 增生的患者相比，这些患者更有可能是吸烟者（33.3% vs. 14.3%，p=0.012），VTI（1.14±0.11 [平均值±标准差] vs. 1.06±0.12，p=0.035）也更高。多变量分析显示，VTI（调整后的几率比=28.490，95%置信区间=1.025-792.046，P=0.048）与iVADA生长独立相关：本研究发现了VA迂曲与iVADA增长之间的独立关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neurology 医学-临床神经学

CiteScore

4.50

自引率

6.50%

发文量

审稿时长

>12 weeks

期刊介绍： The JCN aims to publish the cutting-edge research from around the world. The JCN covers clinical and translational research for physicians and researchers in the field of neurology. Encompassing the entire neurological diseases, our main focus is on the common disorders including stroke, epilepsy, Parkinson''s disease, dementia, multiple sclerosis, headache, and peripheral neuropathy. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, and letters to the editor. The JCN will allow clinical neurologists to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism.