Abstract
Background and PurposeHemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology.Materials and Methods3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs). Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture.ResultsThe normalized mean wall shear stress (WSS) of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012). The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018). The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012). By contrast, parameters that had no significant differences between the two groups were OSI (P = .674), aneurysm size (P = .327), size ratio (P = .779), vessel angle (P = 1.000) and aneurysm inclination angle (P = 1.000).ConclusionsPcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.
Highlights
For a variety of reasons, an increasing number of asymptomatic unruptured intracranial aneurysms (IAs) have been discovered recently
Parameters that had no significant differences between the two groups were oscillatory shear index (OSI) (P = .674), aneurysm size (P = .327), size ratio (P = .779), vessel angle (P = 1.000) and aneurysm inclination angle (P = 1.000)
Hemodynamics is as important as morphology in discriminating aneurysm rupture status
Summary
For a variety of reasons, an increasing number of asymptomatic unruptured intracranial aneurysms (IAs) have been discovered recently. It is very difficult to obtain the patient-specific boundary conditions in clinical applications In this context, analyzing the risk of aneurysm rupture with mirror aneurysms (MANs), defined as bilateral saccular aneurysms at roughly the same locations on each side in the same patient in accordance with G. The morphology of aneurysm and parent artery exerts a more significant influence on hemodynamic results than the boundary conditions. [6] taking advantage of MANs, the morphology-based hemodynamic study has a great significance to explore the hemodynamic mechanism of aneurysm ruptures. We chose the Pcom-MANs for morphological and hemodynamic research, so as to discover the dangerous factors of rupture. We aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology
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