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Neurosurg Rev. 2018 Sep 21. doi: 10.1007/s10143-018-1027-0. [Epub ahead of print]

Hemodynamic findings associated with intraoperative appearances of intracranial aneurysms.

Jiang P1,2,3,4, Liu Q1,2,3,4, Wu J1,2,3,4, Chen X1,2,3,4, Li M1,2,3,4, Yang F1,2,3,4, Li Z1,2,3,4, Yang S1,2,3,4, Guo R1,2,3,4, Gao B5, Cao Y1,2,3,4, Wang R1,2,3,4, Di F6,7,8,9, Wang S10,11,12,13.

Author information

1
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
2
China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.
3
Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
4
Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People's Republic of China.
5
School of Life Science and BioEngineering, Beijing University of Technology, Beijing, People's Republic of China.
6
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. difeittyy@aliyun.com.
7
China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China. difeittyy@aliyun.com.
8
Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China. difeittyy@aliyun.com.
9
Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People's Republic of China. difeittyy@aliyun.com.
10
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. captain9858@126.com.
11
China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China. captain9858@126.com.
12
Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China. captain9858@126.com.
13
Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People's Republic of China. captain9858@126.com.

Abstract

Intracranial aneurysms can be classified into thick-walled aneurysms and thin-walled aneurysms according to their intraoperative appearances; previous publications have revealed that different kinds of intraoperative appearances were associated with intraoperative rupture and postoperative complications. Here, we tried to evaluate the association between hemodynamic features and aneurysm wall appearance using computational fluid dynamics (CFD) method. Forty-one consecutive patients with unruptured middle cerebral artery (MCA) bifurcation aneurysms were included in our study. Based on the appearances observed under the microscope, aneurysms were classified into two different types: thick-walled and thin-walled aneurysms. Preoperative computed tomographic angiography (CTA) was used for geometry reconstruction and CFD analysis. Morphological and hemodynamic parameters were compared between the two groups. Eighteen aneurysms were classified as thick-walled atherosclerotic ones according to their intraoperative appearances. Compared with thin-walled aneurysms, aneurysms with atherosclerotic changes had larger geometry parameters (aneurysm depth, maximum height, diameter, aspect ratio, size ratio), lower wall shear stress (WSS), and larger low WSS area ratio (LSAR). Thick-walled aneurysms characterized by atherosclerotic changes are associated with low WSS and larger LSAR. CFD may be a useful tool for discriminating the intraoperative appearance of cerebral aneurysms.

KEYWORDS:

Atherosclerotic change; Cerebral aneurysm; Hemodynamics; Intraoperative appearance; Wall shear stress

PMID:
30242546
DOI:
10.1007/s10143-018-1027-0

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