• Xin Feng, Baorui Zhang, Erkang Guo, Luyao Wang, Zenguhi Qian, Peng Liu, Xiaolong Wen, Wenjuan Xu, Chuhan Jiang, Youxiang Li, Zhongxue Wu, and Aihua Liu.
• Beijing Neurosurgical Institute and Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
• World Neurosurg. 2017 Nov 1; 107: 255-262.

Background And ObjectivePrevious studies firmly proved that an irregular aneurysmal shape was associated strongly with intracranial aneurysm (IA) rupture, but it is unclear how irregularly shaped IAs form. We aimed to identify the factors related to irregular shape of IAs.MethodsWe retrospectively analyzed of consecutive patients evaluated or treated for IA at our institution from June 2015 to July 2016. According to the imaging morphology of aneurysm, the enrolled patients were divided into irregular and regular group. Demographic data and imaging data of the 2 groups were compared to identify the factors related to aneurismal irregular shape.ResultsThere were 429 aneurysms (180 irregular and 249 regular aneurysms), including 315 unruptured aneurysms and 114 ruptured aneurysms. Most unruptured aneurysms occurred in the internal carotid arteries (53.3%), anterior communicating artery (10.8%), and posterior communicating artery (10.8%), anterior cerebral artery (5.4%), middle cerebral artery (9.8%), and posterior circulation (9.8%). In univariate analysis, for unruptured aneurysm, irregular aneurysmal shape was significantly related to aneurysm size (P = 0.009), aspect ratio (P = 0.003), size ratio (P = 0.002), and location at the bifurcation (P = 0.009) but not with smoking status, hypertension, hyperlipidemia, or diabetes mellitus. In multivariate logistic analysis, irregular aneurysms occurred mainly in unruptured aneurysms with a larger size (diameter ≥5 mm; odds ratio [OR] 2.106; 95% confidence interval [CI] 1.183-3.749; P = 0.011); location at a bifurcation (OR 2.017; 95% CI 1.191-3.413; P = 0.006), and aspect ratio (≥0.8; OR 4.992; 95% CI 1.318-18.915; P = 0.018).ConclusionsLocation at a bifurcation, an increased aneurysm size, and greater aspect ratio are significant independent factors associated with an irregular shape in unruptured IAs but not with smoking status, hypertension, hyperlipidemia, or diabetes mellitus.Copyright © 2017 Elsevier Inc. All rights reserved.

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