Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development

OBJECTIVES: We analysed tortuosity of basilar artery (BA) to determine its relationship with the presence of aneurysm. METHODS: We retrospectively analysed 71 patients with BA aneurysms along with 71 age- and risk factors-matched control patients without BA aneurysm. From patients’ medical records, we obtained their history including previous and current diseases and medications. For each patient, we calculated relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD) and inflexion count metrics (ICM). We used t-test and Mann-Whitney U test for continuous variables and χ(2) test for dichotomised variables. To find independent predictors of BA aneurysm, we employed logistic regression analysis. RESULTS: We found significant positive correlation between age and SOAM (R = 0.195, p = 0.02) and PAD (R = 0.199, p = 0.018). Our study also showed that patients with BA aneurysm had significantly higher SOAM (0.21 ± 0.16 vs. 0.11 ± 0.08; p < 0.01), PAD (0.30 ± 0.19 vs. 0.18 ± 0.11; p < 0.01), TI (0.23 ± 0.23 vs. 0.10 ± 0.16; p < 0.01) and ICM (0.20 ± 0.16 vs. 0.15 ± 0.11; p = 0.045). In multivariate logistic regression analysis, after adjustment for all possible confounders, SOAM (OR = 1.086; 95% CI 1.046–1.136; p < 0.01) and TI (OR = 1.004; 95%C: 1.002–1.006; p < 0.01) remained independently associated with higher risk of BA aneurysm. CONCLUSIONS: Increased tortuosity of BA is associated with higher risk of its aneurysm development. KEY POINTS: • Basilar artery sum of angle metrics and product of angle distance are correlated with age. • Basilar artery tortuosity is independently associated with higher risk of its aneurysm development. • Basilar artery tortuosity is positively correlated with its diameter and bifurcation angle.