scholarly journals Analysis of Morphological-Hemodynamic Risk Factors for Aneurysm Rupture Including a Newly Introduced Total Volume Ratio

2021 ◽  
Vol 11 (8) ◽  
pp. 744
Author(s):  
Ui Yun Lee ◽  
Hyo Sung Kwak
Keyword(s):  
Shear Stress ◽  
Aspect Ratio ◽  
Wall Shear Stress ◽  
Volume Ratio ◽  
Wall Stress ◽  
Aneurysm Rupture ◽  
Oscillatory Shear Index ◽  
Unstable Flow ◽  
Ruptured Aneurysms ◽  
Wall Shear

The purpose of this study was to evaluate morphological and hemodynamic factors, including the newly developed total volume ratio (TVR), in evaluating rupture risk of cerebral aneurysms using ≥7 mm sized aneurysms. Twenty-three aneurysms (11 unruptured and 12 ruptured) ≥ 7 mm were analyzed from 3-dimensional rotational cerebral angiography and computational fluid dynamics (CFD). Ten morphological and eleven hemodynamic factors of the aneurysms were qualitatively and quantitatively compared. Correlation analysis between morphological and hemodynamic factors was performed, and the relationship among the hemodynamic factors was analyzed. Morphological factors (ostium diameter, ostium area, aspect ratio, and bottleneck ratio) and hemodynamic factors (TVR, minimal wall shear stress of aneurysms, time-averaged wall shear stress of aneurysms, oscillatory shear index, relative residence time, low wall shear stress area, and ratio of low wall stress area) were statistically different between ruptured and unruptured aneurysms (p < 0.05). By simple regression analysis, the morphological factor aspect ratio and the hemodynamic factor TVR were significantly correlated (r2 = 0.602, p = 0.001). Ruptured aneurysms had complex and unstable flow. In ≥7 mm ruptured aneurysms, high aspect ratio, bottleneck ratio, complex flow, unstable flow, low TVR, wall shear stress at aneurysm, high oscillatory shear index, relative resistance time, low wall shear stress area, and ratio of low wall stress area were significant in determining the risk of aneurysm rupture.

STUDY ON THE RELATIONSHIP BETWEEN WALL SHEAR STRESS AND ASPECT RATIO OF CEREBRAL ANEURYSMS WITH DIFFERENT PRESSURE DIFFERENCES USING CFD SIMULATIONS

2018 ◽  
Vol 18 (05) ◽  
pp. 1850055
Author(s):  
ALFREDO ARANDA ◽  
ALVARO VALENCIA
Keyword(s):  
Shear Stress ◽  
Aspect Ratio ◽  
Wall Shear Stress ◽  
Cerebral Aneurysms ◽  
Cfd Simulations ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Sphericity Index ◽  
Wall Shear ◽  
The Relationship

CFD simulations were performed for 60 human cerebral aneurysms (30 previously ruptured and 30 previously unruptured) to study the behavior of the time-averaged wall shear stress (TAWSS) with respect to the aspect ratio (AR), implementing a set of low, normal, and high-pressure differences between the inlet and the outlets of each artery. It is well known that there exists a direct relationship between TAWSS and the rupture. In this investigation, we presented an important result because the condition of the pressure among the branches and the AR may be measured in any patient, then a slope may be associated, and finally a TAWSS may be estimated. We found that when the pressure difference increased, the absolute slopes between TAWSS and AR increased as well. Also, the magnitude of the slope in the previously unruptured aneurysms was 4.7 times the slope in the previously ruptured aneurysms. On the other hand, TAWSS was higher in the previously unruptured aneurysm than previously ruptured aneurysms due to the unruptured aneurysms that have a smaller surface area. Furthermore, we analyzed the relationship between TAWSS and other geometric parameters of the aneurysm, such as bottleneck and non-sphericity index; however, no correlation was found for either cases.

Impact of bifurcation angle and inflow coefficient on the rupture risk of bifurcation type basilar artery tip aneurysms

2018 ◽  
Vol 128 (3) ◽  
pp. 723-730 ◽  
Author(s):  
Sherif Rashad ◽  
Shin-ichiro Sugiyama ◽  
Kuniyasu Niizuma ◽  
Kenichi Sato ◽  
Hidenori Endo ◽  
...  
Keyword(s):  
Shear Stress ◽  
Aspect Ratio ◽  
Wall Shear Stress ◽  
Univariate Analysis ◽  
Aneurysm Rupture ◽  
Parent Artery ◽  
Maximum Height ◽  
Rupture Risk ◽  
Bifurcation Angle ◽  
Wall Shear

OBJECTIVERisk factors for aneurysm rupture have been extensively studied, with several factors showing significant correlations with rupture status. Several studies have shown that aneurysm shape and hemodynamics change after rupture. In the present study the authors investigated a static factor, the bifurcation angle, which does not change after rupture, to understand its effect on aneurysm rupture risk and hemodynamics.METHODSA hospital database was retrospectively reviewed to identify patients with cerebral aneurysms treated surgically or endovascularly in the period between 2008 and 2015. After acquiring 3D rotational angiographic data, 3D stereolithography models were created and computational fluid dynamic analysis was performed using commercially available software. Patient data (age and sex), morphometric factors (aneurysm volume and maximum height, aspect ratio, bifurcation angle, bottleneck ratio, and neck/parent artery ratio), and hemodynamic factors (inflow coefficient and wall shear stress) were statistically compared between ruptured and unruptured groups.RESULTSSeventy-one basilar tip aneurysms were included in this study, 22 ruptured and 49 unruptured. Univariate analysis showed aspect ratio, bifurcation angle, bottleneck ratio, and inflow coefficient were significantly correlated with a ruptured status. Logistic regression analysis showed that aspect ratio and bifurcation angle were significant predictors of a ruptured status. Bifurcation angle was inversely correlated with inflow coefficient (p < 0.0005), which in turn correlated directly with mean (p = 0.028) and maximum (p = 0.014) wall shear stress (WSS) using Pearson's correlation coefficient, whereas aspect ratio was inversely correlated with mean (0.012) and minimum (p = 0.018) WSS.CONCLUSIONSBifurcation angle and aspect ratio are independent predictors for aneurysm rupture. Bifurcation angle, which does not change after rupture, is correlated with hemodynamic factors including inflow coefficient and WSS, as well as rupture status. Aneurysms with the hands-up bifurcation configuration are more prone to rupture than aneurysms with other bifurcation configurations.

Quantification of hemodynamic irregularity using oscillatory velocity index in the associations with the rupture status of cerebral aneurysms

2019 ◽  
Vol 11 (6) ◽  
pp. 614-617 ◽  
Author(s):  
Satoru Tanioka ◽  
Fujimaro Ishida ◽  
Tomoyuki Kishimoto ◽  
Masanori Tsuji ◽  
Katsuhiro Tanaka ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Cerebral Aneurysms ◽  
Flow Patterns ◽  
Hemodynamic Parameter ◽  
Hemodynamic Parameters ◽  
Unstable Flow ◽  
Ruptured Aneurysms ◽  
Oscillatory Velocity ◽  
Wall Shear

BackgroundComplex and unstable flow patterns are reported to be associated with the rupture status of cerebral aneurysms, while their evaluation depends on qualitative analysis of streamlines of bloodflow. Oscillatory velocity index (OVI) is a hemodynamic parameter to quantify flow patterns. The aim of this study is to elucidate the associations between OVI and the rupture status of cerebral aneurysms.MethodsOne hundred and twenty-nine ruptured and unruptured cerebral aneurysms were analyzed with computational fluid dynamics under pulsatile flow conditions. With the use of median value of OVI, all aneurysms were divided into high and low OVI groups. Statistical analysis was performed to compare rupture status, and morphological and hemodynamic parameters between the two groups.ResultsThe median value of OVI was 0.006. High OVI was more likely observed in ruptured aneurysms (P=0.028) and associated with irregular shape, complex flow patterns, and unstable flow patterns (P<0.001, respectively). In morphological parameters, maximum size, aspect, projection, size, and volume-to-ostium area ratios were significantly higher in the high OVI group (P<0.001, respectively). In hemodynamic parameters, wall shear stress and wall shear stress gradient were significantly lower, and oscillatory shear index and gradient oscillatory number were significantly higher in the high OVI group (P<0.001, respectively).ConclusionHigh OVI was associated with rupture status, and morphological and hemodynamic characteristics of ruptured aneurysms. These results indicate that OVI may serve as a valuable hemodynamic parameter for diagnosing rupture status and risks of aneurysms.

Changes in wall shear stress magnitude after aneurysm rupture

2013 ◽  
Vol 155 (8) ◽  
pp. 1559-1563 ◽  
Author(s):  
Kenichi Kono ◽  
Nagatsuki Tomura ◽  
Ryo Yoshimura ◽  
Tomoaki Terada
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Aneurysm Rupture ◽  
Wall Shear

Clinical, morphological, and hemodynamic independent characteristic factors for rupture of posterior communicating artery aneurysms

2015 ◽  
Vol 8 (8) ◽  
pp. 808-812 ◽  
Author(s):  
Ying Zhang ◽  
Linkai Jing ◽  
Jian Liu ◽  
Chuanhui Li ◽  
Jixing Fan ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Aneurysm Rupture ◽  
Irregular Shape ◽  
Posterior Communicating Artery ◽  
Patient Specific ◽  
Younger Age ◽  
Wall Shear

ObjectiveTo identify clinical, morphological, and hemodynamic independent characteristic factors that discriminate posterior communicating artery (PCoA) aneurysm rupture status.Methods173 patients with single PCoA aneurysms (108 ruptured, 65 unruptured) between January 2012 and June 2014 were retrospectively collected. Patient-specific models based on their three-dimensional digital subtraction angiography images were constructed and analyzed by a computational fluid dynamic method. All variables were analyzed by univariate analysis and multivariate logistic regression analysis.ResultsTwo clinical factors (younger age and atherosclerosis), three morphological factors (higher aspect ratio, bifurcation type, and irregular shape), and six hemodynamic factors (lower mean and minimum wall shear stress, higher oscillatory shear index, a greater portion of area under low wall shear stress, unstable and complex flow pattern) were significantly associated with PCoA aneurysm rupture. Independent factors characterizing the rupture status were identified as age (OR 0.956, p=0.015), irregular shape (OR 6.709, p<0.001), and minimum wall shear stress (OR 0.001, p=0.038).ConclusionsWe combined clinical, morphological, and hemodynamic characteristics analysis and found the three strongest independent factors for PCoA aneurysm rupture were younger age, irregular shape, and low minimum wall shear stress. This may be useful for guiding risk assessments and subsequent treatment decisions for PCoA aneurysms.

Effects of smoking and hypertension on wall shear stress and oscillatory shear index at the site of intracranial aneurysm formation

2010 ◽  
Vol 112 (4) ◽  
pp. 306-313 ◽  
Author(s):  
Pankaj K. Singh ◽  
Alberto Marzo ◽  
Bethany Howard ◽  
Daniel A. Rufenacht ◽  
Philippe Bijlenga ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Intracranial Aneurysm ◽  
Oscillatory Shear ◽  
Oscillatory Shear Index ◽  
Aneurysm Formation ◽  
Wall Shear

scholarly journals Mis-sizing of stent promotes intimal hyperplasia: impact of endothelial shear and intramural stress

2011 ◽  
Vol 301 (6) ◽  
pp. H2254-H2263 ◽  
Author(s):  
Henry Y. Chen ◽  
Anjan K. Sinha ◽  
Jenny S. Choy ◽  
Hai Zheng ◽  
Michael Sturek ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Coronary Arteries ◽  
Vessel Wall ◽  
Solid Mechanics ◽  
Linear Regression Analysis ◽  
Wall Stress ◽  
Linear Relations ◽  
Flow Disturbances ◽  
Wall Shear

Stent can cause flow disturbances on the endothelium and compliance mismatch and increased stress on the vessel wall. These effects can cause low wall shear stress (WSS), high wall shear stress gradient (WSSG), oscillatory shear index (OSI), and circumferential wall stress (CWS), which may promote neointimal hyperplasia (IH). The hypothesis is that stent-induced abnormal fluid and solid mechanics contribute to IH. To vary the range of WSS, WSSG, OSI, and CWS, we intentionally mismatched the size of stents to that of the vessel lumen. Stents were implanted in coronary arteries of 10 swine. Intravascular ultrasound (IVUS) was used to size the coronary arteries and stents. After 4 wk of stent implantation, IVUS was performed again to determine the extent of IH. In conjunction, computational models of actual stents, the artery, and non-Newtonian blood were created in a computer simulation to yield the distribution of WSS, WSSG, OSI, and CWS in the stented vessel wall. An inverse relation ( R2 = 0.59, P < 0.005) between WSS and IH was found based on a linear regression analysis. Linear relations between WSSG, OSI, and IH were observed ( R2 = 0.48 and 0.50, respectively, P < 0.005). A linear relation ( R2 = 0.58, P < 0.005) between CWS and IH was also found. More statistically significant linear relations between the ratio of CWS to WSS (CWS/WSS), the products CWS × WSSG and CWS × OSI, and IH were observed ( R2 = 0.67, 0.54, and 0.56, respectively, P < 0.005), suggesting that both fluid and solid mechanics influence the extent of IH. Stents create endothelial flow disturbances and intramural wall stress concentrations, which correlate with the extent of IH formation, and these effects were exaggerated with mismatch of stent/vessel size. These findings reveal the importance of reliable vessel and stent sizing to improve the mechanics on the vessel wall and minimize IH.

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