Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms
Background and purposeThe relationship between the tortuosity of the parent artery and treatment outcomes is not well established. We investigate the association between parent artery tortuosity and flow diverter (FD) treatment outcomes in patients with internal carotid artery aneurysms in this stud...
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| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1034402/full |
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| author | Haibin Gao Haibin Gao Haibin Gao Wei You Wei You Dachao Wei Dachao Wei Jian Lv Jian Lv Wei Sun Wei Sun Youxiang Li Youxiang Li |
| author_facet | Haibin Gao Haibin Gao Haibin Gao Wei You Wei You Dachao Wei Dachao Wei Jian Lv Jian Lv Wei Sun Wei Sun Youxiang Li Youxiang Li |
| author_sort | Haibin Gao |
| collection | DOAJ |
| description | Background and purposeThe relationship between the tortuosity of the parent artery and treatment outcomes is not well established. We investigate the association between parent artery tortuosity and flow diverter (FD) treatment outcomes in patients with internal carotid artery aneurysms in this study.MethodsA retrospective review study was conducted to identify all patients with internal carotid artery aneurysms who were implanted with Pipeline embolization device (PED) between 2016 and 2020. The relationship between parent artery tortuosity and aneurysm complete occlusion (CO) and in-stent stenosis (ISS) was analyzed. The mathematical parameters “Curvature”, “torsion”, and “DM” extracted from the parent artery were utilized to quantify the parent artery tortuosity. A vascular narrowing of greater than 25% was categorized as ISS. Logistic regression analysis was used to identify significant independent predictors. Furthermore, we compared the performance of four machine learning algorithms and Logistic Regression model in predicting ISS.ResultsThis research included 62 patients who with internal carotid artery aneurysms. In 49 (79%) cases, follow-up angiography (mean follow-up duration 11.7 ±7.3 months) revealed CO of the aneurysm. ISS was detected in 22 (35.5%) cases. According to univariate analysis, parent artery tortuosity and other variables were not associated with CO (p > 0.1). Maximum curvature (OR = 1.084; 95% CI, 1.008–1.165; p = 0.03) and DM (OR = 0.01; 95% CI, 0–0.488; p = 0.02) exhibited strong independent associations with ISS in multivariate analysis. The SVM model is superior to the conventional Logistic Regression model and the other models in predicting ISS.ConclusionsThe tortuosity of the parent artery may affect the treatment outcome of FD stenting. We found that parent artery tortuosity was associated with ISS, but not with aneurysm complete occlusion following PED stenting for internal carotid artery aneurysms in this study. Parent arteries with higher maximum curvature and lower DM were more likely to develop ISS. |
| first_indexed | 2024-04-14T00:00:53Z |
| format | Article |
| id | doaj.art-10de325dd617473895651b9bcd0cd8df |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-14T00:00:53Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-10de325dd617473895651b9bcd0cd8df2022-12-22T02:23:42ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-10-011310.3389/fneur.2022.10344021034402Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysmsHaibin Gao0Haibin Gao1Haibin Gao2Wei You3Wei You4Dachao Wei5Dachao Wei6Jian Lv7Jian Lv8Wei Sun9Wei Sun10Youxiang Li11Youxiang Li12Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, ChinaCollege of Rehabilitation, Capital Medical University, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBeijing Engineering Research Center, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBeijing Engineering Research Center, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBeijing Engineering Research Center, Beijing, ChinaDepartment of Neurosurgery, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, ChinaCollege of Rehabilitation, Capital Medical University, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBeijing Engineering Research Center, Beijing, ChinaBackground and purposeThe relationship between the tortuosity of the parent artery and treatment outcomes is not well established. We investigate the association between parent artery tortuosity and flow diverter (FD) treatment outcomes in patients with internal carotid artery aneurysms in this study.MethodsA retrospective review study was conducted to identify all patients with internal carotid artery aneurysms who were implanted with Pipeline embolization device (PED) between 2016 and 2020. The relationship between parent artery tortuosity and aneurysm complete occlusion (CO) and in-stent stenosis (ISS) was analyzed. The mathematical parameters “Curvature”, “torsion”, and “DM” extracted from the parent artery were utilized to quantify the parent artery tortuosity. A vascular narrowing of greater than 25% was categorized as ISS. Logistic regression analysis was used to identify significant independent predictors. Furthermore, we compared the performance of four machine learning algorithms and Logistic Regression model in predicting ISS.ResultsThis research included 62 patients who with internal carotid artery aneurysms. In 49 (79%) cases, follow-up angiography (mean follow-up duration 11.7 ±7.3 months) revealed CO of the aneurysm. ISS was detected in 22 (35.5%) cases. According to univariate analysis, parent artery tortuosity and other variables were not associated with CO (p > 0.1). Maximum curvature (OR = 1.084; 95% CI, 1.008–1.165; p = 0.03) and DM (OR = 0.01; 95% CI, 0–0.488; p = 0.02) exhibited strong independent associations with ISS in multivariate analysis. The SVM model is superior to the conventional Logistic Regression model and the other models in predicting ISS.ConclusionsThe tortuosity of the parent artery may affect the treatment outcome of FD stenting. We found that parent artery tortuosity was associated with ISS, but not with aneurysm complete occlusion following PED stenting for internal carotid artery aneurysms in this study. Parent arteries with higher maximum curvature and lower DM were more likely to develop ISS.https://www.frontiersin.org/articles/10.3389/fneur.2022.1034402/fullIntracranial AneurysmsPipeline embolization device (PED)vascular tortuosityin stent stenosisinternal carotid artery (ICA) |
| spellingShingle | Haibin Gao Haibin Gao Haibin Gao Wei You Wei You Dachao Wei Dachao Wei Jian Lv Jian Lv Wei Sun Wei Sun Youxiang Li Youxiang Li Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms Frontiers in Neurology Intracranial Aneurysms Pipeline embolization device (PED) vascular tortuosity in stent stenosis internal carotid artery (ICA) |
| title | Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms |
| title_full | Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms |
| title_fullStr | Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms |
| title_full_unstemmed | Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms |
| title_short | Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms |
| title_sort | tortuosity of parent artery predicts in stent stenosis after pipeline flow diverter stenting for internal carotid artery aneurysms |
| topic | Intracranial Aneurysms Pipeline embolization device (PED) vascular tortuosity in stent stenosis internal carotid artery (ICA) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1034402/full |
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