Aneurysm Growth Occurs at Region of Low Wall Shear Stress

Boussel, Loîc; Rayz, Vitaliy L.; McCulloch, Charles E.; Martin, Alastair J.; Acevedo-Bolton, Gabriel; Lawton, Michael T.; Higashida, Randall T.; Smith, Wade S.; Young, William L.; Saloner, David

doi:10.1161/strokeaha.108.521617

Cited by 444 publications

(235 citation statements)

References 29 publications

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“…In the past, research analyzing unruptured aneurysms found that aneurysm growth was likely to occur at low WSS areas. 23 Our data showed that changes in aneurysm shape are not restricted to low WSS regions. As previously reported by Kono et al 24 in a study of a single posterior communicating artery aneurysm, we also found WSS changes before and after rupture.…”

Section: Discussionmentioning

confidence: 47%

Morphologic and Hemodynamic Risk Factors in Ruptured Aneurysms Imaged before and after Rupture

Chien¹,

Sayre

2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Due to limited information about aneurysm natural history, choosing the appropriate management strategy for an unruptured aneurysm is challenging. By comparing unruptured and ruptured cases, studies have identified a variety of aneurysm morphologic and hemodynamic properties as risk factors for rupture. In this study, we investigated changes in 4 ruptured aneurysms before and after rupture and tested whether previously published risk factors identified a risk before rupture.

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Section: Discussionmentioning

confidence: 47%

Morphologic and Hemodynamic Risk Factors in Ruptured Aneurysms Imaged before and after Rupture

Chien¹,

Sayre

2014

AJNR Am J Neuroradiol

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“…Multiple applications of CFD for the evaluation of human flow characteristics have been reported in the past years including, for example, the simulation of time-resolved 3D flow patterns in the left ventricle, in geometrically complex aneurysms, or the carotid artery bifurcation (41)(42)(43)(44)(45). Such numerical simulations permit the detailed analysis of local flow patterns and calculation of additional relevant parameters such as pressure differences or wall shear rates.…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional analysis of segmental wall shear stress in the aorta by flow‐sensitive four‐dimensional‐MRI

Frydrychowicz

Stalder

Russe

et al. 2009

Magnetic Resonance Imaging

164

138

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Purpose:To assess the distribution and regional differences of flow and vessel wall parameters such as wall shear stress (WSS) and oscillatory shear index (OSI) in the entire thoracic aorta. Materials and Methods:Thirty-one healthy volunteers (mean age ϭ 23.7 Ϯ 3.3 years) were examined by flow-sensitive four-dimensional (4D)-MRI at 3T. For eight retrospectively positioned 2D analysis planes distributed along the thoracic aorta, flow parameters and vectorial WSS and OSI were assessed in 12 segments along the vascular circumference. Conclusion:The normal distribution of vectorial WSS and OSI in the entire thoracic aorta derived from flow-sensitive 4D-MRI data provides a reference constituting an important perquisite for the examination of patients with aortic disease. Marked regional differences in absolute WSS and OSI may help explaining why atherosclerotic lesions predominantly develop and progress at specific locations in the aorta. COMPLEX VASCULAR GEOMETRY AND PULSATILE FLOW in the human arterial system lead to regionally different flow characteristics and thus spatial and temporal changes in shear forces acting on the vessel wall. These forces can be characterized by wall shear stress (WSS) or oscillatory shear index (OSI) that play an important role in flow-mediated atherogenesis and arterial remodeling (1-3). While WSS values reported in the literature typically reflect the time-averaged shear forces acting on the vessel wall, OSI describes the existence and magnitude of WSS changes over the cardiac cycle. Recent reports stressed the importance of WSS and OSI with respect to the formation and stability of atherosclerotic plaques (4). A number of studies have shown that low WSS and high OSI represent sensitive markers for formation of plaques in the aorta, carotid, or coronary arteries (5,6). Particularly, the assessment of both WSS and OSI can help to determine the complexity of the lesions. A recent study with animal models and deliberately altered flow characteristics in the carotid arteries demonstrated the close correlation of low WSS with the development of vulnerable high-risk plaques whereas high OSI induce stable lesions (4). In addition, the effects of selected pathologies on regionally-varying WSS and OSI values have been reported (7,8).Among other methods, MRI is a feasible and extensively validated technique to derive quantitative flow information from arterial vessels (9 -12). Due to its intrinsic sensitivity to flow and the possibility to acquire true time-resolved three-dimensional (3D) data, in vivo analyses of blood-flow and derived vessel wall parameters are promising. However, earlier reports on MRbased analysis of aortic hemodynamics were either based on incomplete vascular coverage and separately acquired 2D slices (13-17), a combination of MR mea-

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“…However, one can foresee several applications in the future: 1) predicting thrombosis in stented aneurysms, 6 and 2) adapting CFD to perioperative patient-specific conditions. Furthermore, an extension of the OF method in 3D would help give more quantitative insight on both the measurements of flow-pattern complexity and related parameters such as wall shear stress in aneurysms, which are believed to play an important role in all aspects of aneurysm growth, 9 rupture, 10 and clotting. compared the intra-aneurysmal flow structures of 3 patients between conventional DSA and virtual angiograms and were able to predict, with good agreement, the locations and sizes of the inflow jet, outflow, impaction zone, and vortex structures.…”

Section: Discussionmentioning

confidence: 99%

Intra-Aneurysmal Flow Patterns: Illustrative Comparison among Digital Subtraction Angiography, Optical Flow, and Computational Fluid Dynamics

Brina¹,

Ouared²,

Bonnefous

et al. 2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Digital subtraction angiography is the gold standard vascular imaging and it is used for all endovascular treatment of intracranial anerysms. Optical flow imaging has been described as a potential method to evaluate cerebral hemodynamics through DSA. In this study, we aimed to compare the flow patterns measured during angiography, by using an optical flow method, with those measured by using computational fluid dynamics in intracranial aneurysms.

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Aneurysm Growth Occurs at Region of Low Wall Shear Stress

Cited by 444 publications

References 29 publications

Morphologic and Hemodynamic Risk Factors in Ruptured Aneurysms Imaged before and after Rupture

Morphologic and Hemodynamic Risk Factors in Ruptured Aneurysms Imaged before and after Rupture

Three‐dimensional analysis of segmental wall shear stress in the aorta by flow‐sensitive four‐dimensional‐MRI

Intra-Aneurysmal Flow Patterns: Illustrative Comparison among Digital Subtraction Angiography, Optical Flow, and Computational Fluid Dynamics

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