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Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics
Background: Hemodynamics play an important role in intracranial aneurysm (IA) initiation, growth, and rupture. Yet there remains no definitive quantitative analysis between abnormal hemodynamics and geometrical risk of IA development. Objective: The present study aims to investigate whether abnormal...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707091/ https://www.ncbi.nlm.nih.gov/pubmed/31474923 http://dx.doi.org/10.3389/fneur.2019.00841 |
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author | Wan, Hailin Ge, Liang Huang, Lei Jiang, Yeqing Leng, Xiaochang Feng, Xiaoyuan Xiang, Jianping Zhang, Xiaolong |
author_facet | Wan, Hailin Ge, Liang Huang, Lei Jiang, Yeqing Leng, Xiaochang Feng, Xiaoyuan Xiang, Jianping Zhang, Xiaolong |
author_sort | Wan, Hailin |
collection | PubMed |
description | Background: Hemodynamics play an important role in intracranial aneurysm (IA) initiation, growth, and rupture. Yet there remains no definitive quantitative analysis between abnormal hemodynamics and geometrical risk of IA development. Objective: The present study aims to investigate whether abnormal hemodynamics in IA sacs can be predicted by surrogate geometric markers. Methods: Computational fluid dynamics (CFD) simulations were performed on paraclinoid aneurysms derived from digital subtraction angiography (DSA) of 104 IAs in 104 patients. Four basic IA geometric parameters including maximum height, perpendicular height, maximum width, and neck diameter were measured. Abnormal hemodynamics were defined and quantified as the surface area exposed to low wall shear stress (WSS) and high oscillatory shear index (OSI) using objectively-defined thresholds. Relationships between abnormal hemodynamics and specific geometric parameters were analyzed via multiple linear regression. Results: Adjusting for age, sex, and other clinical characteristics, multiple linear regression revealed a significant relationship (p < 0.001) between abnormal hemodynamics and both maximum width (β ≈ 1.2) and neck diameter (β ≈ −0.4), but not maximum height or perpendicular height. These findings were shown to be independent of the choice of abnormal hemodynamic indicators and threshold levels. Conclusions: Maximum width and neck diameter of IA sacs are robust surrogates of exposure to abnormal hemodynamics. Risk of rupture may be increased with wider aneurysms with narrower necks for paraclinoid aneurysms. |
format | Online Article Text |
id | pubmed-6707091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-67070912019-08-30 Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics Wan, Hailin Ge, Liang Huang, Lei Jiang, Yeqing Leng, Xiaochang Feng, Xiaoyuan Xiang, Jianping Zhang, Xiaolong Front Neurol Neurology Background: Hemodynamics play an important role in intracranial aneurysm (IA) initiation, growth, and rupture. Yet there remains no definitive quantitative analysis between abnormal hemodynamics and geometrical risk of IA development. Objective: The present study aims to investigate whether abnormal hemodynamics in IA sacs can be predicted by surrogate geometric markers. Methods: Computational fluid dynamics (CFD) simulations were performed on paraclinoid aneurysms derived from digital subtraction angiography (DSA) of 104 IAs in 104 patients. Four basic IA geometric parameters including maximum height, perpendicular height, maximum width, and neck diameter were measured. Abnormal hemodynamics were defined and quantified as the surface area exposed to low wall shear stress (WSS) and high oscillatory shear index (OSI) using objectively-defined thresholds. Relationships between abnormal hemodynamics and specific geometric parameters were analyzed via multiple linear regression. Results: Adjusting for age, sex, and other clinical characteristics, multiple linear regression revealed a significant relationship (p < 0.001) between abnormal hemodynamics and both maximum width (β ≈ 1.2) and neck diameter (β ≈ −0.4), but not maximum height or perpendicular height. These findings were shown to be independent of the choice of abnormal hemodynamic indicators and threshold levels. Conclusions: Maximum width and neck diameter of IA sacs are robust surrogates of exposure to abnormal hemodynamics. Risk of rupture may be increased with wider aneurysms with narrower necks for paraclinoid aneurysms. Frontiers Media S.A. 2019-08-14 /pmc/articles/PMC6707091/ /pubmed/31474923 http://dx.doi.org/10.3389/fneur.2019.00841 Text en Copyright © 2019 Wan, Ge, Huang, Jiang, Leng, Feng, Xiang and Zhang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Wan, Hailin Ge, Liang Huang, Lei Jiang, Yeqing Leng, Xiaochang Feng, Xiaoyuan Xiang, Jianping Zhang, Xiaolong Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics |
title | Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics |
title_full | Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics |
title_fullStr | Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics |
title_full_unstemmed | Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics |
title_short | Sidewall Aneurysm Geometry as a Predictor of Rupture Risk Due to Associated Abnormal Hemodynamics |
title_sort | sidewall aneurysm geometry as a predictor of rupture risk due to associated abnormal hemodynamics |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707091/ https://www.ncbi.nlm.nih.gov/pubmed/31474923 http://dx.doi.org/10.3389/fneur.2019.00841 |
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