Calcification in Human Intracranial Aneurysms Is Highly Prevalent and Displays Both Atherosclerotic and Nonatherosclerotic Types

• DOI: 10.1161/atvbaha.119.312922
• Publication Date: 2019-08-29T09:03:14Z
• Authors: Piyusha S. Gade; Riikka Tulamo; Kee-won Lee; Fernando Mut; Eliisa Ollikainen; Chih-Yuan Chuang; Bong Jae Chung; Mika Niemelä; Behnam Rezai Jahromi; Khaled Aziz; Alexander Yu; Fady T. Charbel; Sepideh Amin-Hanjani; Juhana Frösen; Juan R. Cebral; Anne M. Robertson
• Keywords: Analysis of Variance; Calcinosis; Intracranial Aneurysm; X-Ray Microtomography; Aneurysm, Ruptured; Middle Aged; Atherosclerosis; Risk Assessment; Severity of Illness Index; Sampling Studies; Statistics, Nonparametric; 03 medical and health sciences; 0302 clinical medicine; Image Processing, Computer-Assisted; Prevalence; Tissue and Organ Harvesting; Humans; Aged

Although the clinical and biological importance of calcification is well recognized for extracerebral vasculature, its role in cerebral vascular disease, particularly, intracranial aneurysms (IAs), remains poorly understood. Extracerebrally, 2 distinct mechanisms drive calcification, a nonatherosclerotic, rapid mineralization media slower, inflammation driven, atherosclerotic mechanism intima. This study aims to determine prevalence, distribution, type (atherosclerotic, nonatherosclerotic) IAs assess differences occurrence between ruptured unruptured IAs. Approach Results: Sixty-five 65 IA specimens (48 unruptured, 17 ruptured) were resected perioperatively. Calcification lipid pools analyzed nondestructively intact samples using high resolution (0.35 μm) microcomputed tomography. highly prevalent (78%) appearing as micro (<500 µm), meso (500 µm-1 mm), macro (>1 mm) calcifications. manifests both nonatherosclerotic (calcification from pools) presence with 3 wall types: Type I-only no (20/51, 39%), II-calcification pools, not colocalized (19/51, 37%), III-calcification (12/51, 24%). Ruptured either had calcifications or micro- meso-calcifications (Type I II), without macro-calcifications.