• Vanessa M Swiatek, Belal Neyazi, Jorge A Roa, Mario Zanaty, Edgar A Samaniego, Daizo Ishii, Yongjun Lu, I Erol Sandalcioglu, Sylvia Saalfeld, Philipp Berg, and David M Hasan.
• Deparment of Neurosurgery, Otto-von-Guericke University, Magdeburg, Saxony Anhalt, Germany.
• Neurosurgery. 2021 Sep 15; 89 (4): 664671664-671.

BackgroundHigh-resolution vessel wall imaging plays an increasingly important role in assessing the risk of aneurysm rupture.ObjectiveTo introduce an approach toward the validation of the wall enhancement as a direct surrogate parameter for aneurysm stability.MethodsA total of 19 patients harboring 22 incidental intracranial aneurysms were enrolled in this study. The aneurysms were dichotomized according to their aneurysm-to-pituitary stalk contrast ratio using a cutoff value of 0.5 (nonenhancing < 0.5; enhancing ≥ 0.5). We evaluated the association of aneurysm wall enhancement with morphological characteristics, hemodynamic features, and inflammatory chemokines directly measured inside the aneurysm.ResultsDifferences in plasma concentration of chemokines and inflammatory molecules, morphological, and hemodynamic parameters were analyzed using the Welch test or Mann-Whitney U test. The concentration ΔIL-10 in the lumen of intracranial aneurysms with low wall enhancement was significantly increased compared to aneurysms with strong aneurysm wall enhancement (P = .014). The analysis of morphological and hemodynamic parameters showed significantly increased values for aneurysm volume (P = .03), aneurysm area (P = .044), maximal diameter (P = .049), and nonsphericity index (P = .021) for intracranial aneurysms with strong aneurysm wall enhancement. None of the hemodynamic parameters reached statistical significance; however, the total viscous shear force computed over the region of low wall shear stress showed a strong tendency toward significance (P = .053).ConclusionAneurysmal wall enhancement shows strong associations with decreased intrasaccular IL-10 and established morphological indicators of aneurysm instability.© Congress of Neurological Surgeons 2021.

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