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Morphological factors of intracranial aneurysms and the surrounding vasculature could affect aneurysm rupture risk in a location specific manner. Our goal was to identify image-based morphological parameters that correlated with ruptured basilar tip aneurysms. Three-dimensional morphological parameters obtained from CT-angiography (CTA) or digital subtraction angiography (DSA) from 200 patients with basilar tip aneurysms diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016 were evaluated. We examined aneurysm wall irregularity, the presence of daughter domes, hypoplastic, aplastic or fetal PCoAs, vertebral dominance, maximum height, perpendicular height, width, neck diameter, aspect and size ratio, height/width ratio, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. In multivariable analysis, presence of a daughter dome, aspect ratio, and larger flow angle were significantly associated with rupture status. We also introduced two new variables, diameter size ratio and parent-daughter angle ratio, which were both significantly inversely associated with ruptured basilar tip aneurysms. Notably, multivariable analyses also showed that larger diameter size ratio was associated with higher Hunt-Hess score while smaller flow angle was associated with higher Fisher grade. These easily measurable parameters, including a new parameter that is unlikely to be affected by the formation of the aneurysm, could aid in screening strategies in high-risk patients with basilar tip aneurysms. One should note, however, that the changes in parameters related to aneurysm morphology may be secondary to aneurysm rupture rather than causal. [ABSTRACT FROM AUTHOR]

Objective: There have been numerous investigations demonstrating protective effects of a well- grown coronary collateral circulation (CCC) on left ventricular systolic function. N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is released by ventricular myocardium as a result of increased myocardial wall stress. The aim of the study was to evaluate the relationship between CCC and plasma NT-pro-BNP levels. Methods: Study group was retrospectively selected from patients who had a coronary angiography at our center between January 2008 and December 2009. One hundred and thirty patients having at least one totally occluded main coronary artery were included in this study. Collateral circulation was graded according to Rentrop score. Grade 0 and 1 are regarded as poor, and grade 2 and 3 - good CCC. Plasma NT-pro-BNP levels were measured by electro chemiluminescence immuno assay method and left ventricular ejection fraction (LVEF) were measured by modified Simpson method. We used Chi-square, Student t and Mann-Whitney-U tests for statistical analysis. Results: Overall 57 patients were found to have poor CCC and 73 patients have good CCC. Plasma NT-pro-BNP levels (pg/ml)-median (minimum maximum)- were 1319 (48-9753) in poor CCC group and 847 (16-5529) in good CCC group (p=0.004). LVEF was found to be -median (minimum maximum)- 45% (30-55%) in poor CCC group and 50% (30-60%) in good CCC group (p=0.003). Correlation analysis demonstrated that collateral grade was negatively correlated with NT-pro-BNP levels (r=-0.252, p=0.004). Conclusion: We found that plasma NT-pro-BNP levels were more elevated in patients with poor CCC than in patients with good CCC. This finding may be explained with the protective effect of good CCC on LVEF. [ABSTRACT FROM AUTHOR]