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Author:

Liu, Qingyuan (Liu, Qingyuan.) | Jiang, Pengjun (Jiang, Pengjun.) | Wu, Jun (Wu, Jun.) | Gao, Bin (Gao, Bin.) | Wang, Shuo (Wang, Shuo.)

Indexed by:

SCIE PubMed

Abstract:

Background and Objectives: Intraoperative aneurysm rupture (IOR) is a difficult event during the clipping process for intracranial aneurysms, and could result in a bad prognosis. Preoperative discrimination of aneurysms with high risk of IOR is vital for operators. The aim of this study was to explore the hemodynamic-morphological risk factors for the IOR. Methods: In the present study, patients admitted for unruptured IA from January 2012 to April 2018 were retrospectively reviewed. A propensity score matching was performed to match patients. The morphological features and the hemodynamic features were extracted. Differences in the morphologic and hemodynamic parameters were compared. Risk factors associated with IOR were explored. Subsequently, the hemodynamic characteristics in different rupture stages and different regions in IOR aneurysm were compared. Results: 96 cases of patients with aneurysms, were found by the matching process in each group. The statistically significant difference was found in the maximum length (L) (p = 0.041), maximum diameter of body (D) (p = 0.032), aspect ratio (AR) (p < 0.001), non-sphericity index (NSI) (p < 0.001), normalized wall shear stress maximum (NWSSm) (p < 0.001) and oscillatory shear index (OSI) (p < 0.001). A regression analysis demonstrated AR (OR = 7.03, p < 0.001), NWSSm (OR = 15.55, p = 0.014) and OSI (OR = 28.30, p < 0.001) as the independent risk factors for IOR. AR was much larger, and NWSSm and NWSSa were much lower for IAs that ruptured in early or predissection stage than those for IAs that ruptured in dissection stage or clip application stage. NWSSa and NWSSm in rupture area were both lower than those in adjacent area. Conclusion: AR, NWSSm, and OSI are considered three independent risk factors for intraoperative aneurysm rupture, which could serve as predictors. A selection of intervention methods for aneurysms with high AR, low NWSSm, and high OSI should carefully be considered.

Keyword:

computational fluid dynamics morphology aneurysm clipping intraoperative aneurysm rupture hemodynamics

Author Community:

  • [ 1 ] [Liu, Qingyuan]Capital Med Univ, Dept Neurosurg, Beijing Tiantan Hosp, Beijing, Peoples R China
  • [ 2 ] [Jiang, Pengjun]Capital Med Univ, Dept Neurosurg, Beijing Tiantan Hosp, Beijing, Peoples R China
  • [ 3 ] [Wu, Jun]Capital Med Univ, Dept Neurosurg, Beijing Tiantan Hosp, Beijing, Peoples R China
  • [ 4 ] [Wang, Shuo]Capital Med Univ, Dept Neurosurg, Beijing Tiantan Hosp, Beijing, Peoples R China
  • [ 5 ] [Liu, Qingyuan]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 6 ] [Jiang, Pengjun]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 7 ] [Wu, Jun]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 8 ] [Wang, Shuo]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 9 ] [Liu, Qingyuan]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 10 ] [Jiang, Pengjun]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 11 ] [Wu, Jun]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 12 ] [Wang, Shuo]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 13 ] [Liu, Qingyuan]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China
  • [ 14 ] [Jiang, Pengjun]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China
  • [ 15 ] [Wu, Jun]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China
  • [ 16 ] [Wang, Shuo]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China
  • [ 17 ] [Gao, Bin]Beijing Univ Technol, Sch Life Sci & Bioengn, Beijing, Peoples R China

Reprint Author's Address:

  • [Wang, Shuo]Capital Med Univ, Dept Neurosurg, Beijing Tiantan Hosp, Beijing, Peoples R China;;[Wang, Shuo]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;;[Wang, Shuo]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China;;[Wang, Shuo]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China

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Source :

FRONTIERS IN NEUROSCIENCE

ISSN: 1662-453X

Year: 2019

Volume: 13

4 . 3 0 0

JCR@2022

ESI Discipline: NEUROSCIENCE & BEHAVIOR;

ESI HC Threshold:147

Cited Count:

WoS CC Cited Count: 11

SCOPUS Cited Count: 11

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 3

Online/Total:144/10637945
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