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Author:

Jiang, Pengjun (Jiang, Pengjun.) | Liu, Qingyuan (Liu, Qingyuan.) | Wu, Jun (Wu, Jun.) | Chen, Xin (Chen, Xin.) | Li, Maogui (Li, Maogui.) | Li, Zhengsong (Li, Zhengsong.) | Yang, Shuzhe (Yang, Shuzhe.) | Guo, Rui (Guo, Rui.) | Gao, Bin (Gao, Bin.) | Cao, Yong (Cao, Yong.) | Wang, Shuo (Wang, Shuo.)

Indexed by:

Scopus SCIE PubMed

Abstract:

Objective: The aim of the present study is to investigate the potential morphological and hemodynamic risk factors related to intracranial aneurysms (IAs) rupture and establish a system to stratify the risk of IAs rupture to help the clinical decision-making. Methods: Patients admitted to our hospital for single-IAs were selected from January 2012 and January 2018. A propensity score matching was conducted to match patients. The morphological parameters were obtained from high solution CTA images, and the hemodynamic parameters were obtained in accordance with the outcomes of computational fluid dynamics (CFDs) simulation. Differences in the morphologic and hemodynamic parameters were compared. The significant parameters were selected to establish a novel scoring system (Intracranial Aneurysm Rupture Score, IARS). The comparison was drawn between the discriminating accuracy of IARS and the Rupture Resemblance Score (RRS) system to verify the value of IARS. Then, a group of patients with unruptured IAs was stratified into the high risk and low risk groups by IARS and RRS system separately and was followed up for 18-27 months to verify the value of IARS. The outcome of different stratifications was compared. Results: The matching process yielded 167 patients in each group. Differences of statistical significance were found in aneurysm length (p = 0.001), perpendicular height (H) (p < 0.001), aspect ratio (AR) (p < 0.001), size ratio (SR) (p < 0.001), deviated angle (DA) (p < 0.001), normalized average wall shear stress (NWSSa) (p < 0.001), wall shear stress gradient (WSSG) (p < 0.001), low shear area ratio (LSAR) (p = 0.01), and oscillatory shear index (OSI) (p = 0.01). Logistic regression analysis further demonstrated that SR, DA, NWSSa, LSAR, and OSI were the independent risk factors of IAs rupture. SR, DA, LSAR, and OSI were finally selected to establish the IARS. Our present IARS showed a higher discriminating value (AUC 0.81 vs. 0.77) in comparison with the RRS (SR, NWSSa, and OSI). After follow-up, seven patients were subject to IAs rupture. 5/26 in high risk group stratified by IARS, yet 7/57 in high risk group stratified by RRS. The accuracy of IARS was further verified (19.2% vs. 12.3%, AUC for the IARS and the RRS was 0.723 and 0.673, respectively). Conclusion: SR DA, NWSSa, LSAR, and OSI were considered the independent risk factors of IAs rupture. Our novel IARS showed higher accuracy in discriminating IA rupture in comparison with RRS.

Keyword:

computational fluid dynamics rupture hemodynamic intracranial aneurysm morphological

Author Community:

  • [ 1 ] [Jiang, Pengjun]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 2 ] [Liu, Qingyuan]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 3 ] [Wu, Jun]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 4 ] [Chen, Xin]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 5 ] [Li, Maogui]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 6 ] [Li, Zhengsong]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 7 ] [Yang, Shuzhe]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 8 ] [Guo, Rui]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 9 ] [Cao, Yong]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 10 ] [Wang, Shuo]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
  • [ 11 ] [Jiang, Pengjun]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 12 ] [Liu, Qingyuan]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 13 ] [Wu, Jun]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 14 ] [Chen, Xin]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 15 ] [Li, Maogui]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 16 ] [Li, Zhengsong]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 17 ] [Yang, Shuzhe]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 18 ] [Guo, Rui]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 19 ] [Cao, Yong]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 20 ] [Wang, Shuo]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
  • [ 21 ] [Jiang, Pengjun]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 22 ] [Liu, Qingyuan]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 23 ] [Wu, Jun]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 24 ] [Chen, Xin]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 25 ] [Li, Maogui]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 26 ] [Li, Zhengsong]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 27 ] [Yang, Shuzhe]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 28 ] [Guo, Rui]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 29 ] [Cao, Yong]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 30 ] [Wang, Shuo]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
  • [ 31 ] [Gao, Bin]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China
  • [ 32 ] [Gao, Bin]Beijing Univ Technol, Sch Life Sci, Dept Bioengn, Beijing, Peoples R China

Reprint Author's Address:

  • [Wang, Shuo]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, 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

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Source :

FRONTIERS IN NEUROSCIENCE

ISSN: 1662-453X

Year: 2018

Volume: 12

4 . 3 0 0

JCR@2022

ESI Discipline: NEUROSCIENCE & BEHAVIOR;

ESI HC Threshold:189

Cited Count:

WoS CC Cited Count: 32

SCOPUS Cited Count: 36

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 7

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