Effect of Bifurcation Angle Configuration and Ratio of Daughter Diameters on Hemodynamics of Bifurcation Aneurysms

Farnoush, A.; Avolio, Alberto; Qian, Yi

doi:10.3174/ajnr.a3222

Cited by 27 publications

(17 citation statements)

References 27 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The authors reported that increasing the DA ratio from 1 to 2 decreased the blood flow into the aneurysm by up to 38%. 4 Similarly Sadatomo et al also observed lower DA ratios in ruptured aneurysms, indicating that the more the difference in diameters of branches, the higher the risk of rupture. However, in our study of basilar bifurcation aneurysms, we did not find any difference in DA ratios between ruptured and unruptured aneurysms.…”

Section: Discussionmentioning

confidence: 89%

“…In a computational fluid hemodynamics study, the authors reported that the highest rate of inflow and EL occur at a DA of 1, when the diameters of both the branches are similar and symmetric flow distribution is observed between the branches. 4 In another study involving middle cerebral artery bifurcation aneurysms, a higher aspect ratio and a lower DA was observed in ruptured compared with unruptured aneurysms. 5 In the present study, we attempt to analyze the aspect ratio, direction of aneurysm projection, lateral angle ratio (LA), and DA of patients with basilar bifurcation aneurysms and correlate with their rupture status.…”

Section: Introductionmentioning

confidence: 92%

See 1 more Smart Citation

Morphological Differences between Ruptured and Unruptured Basilar Bifurcation Aneurysms

et al. 2013

View full text Add to dashboard Cite

Background Aspect ratio (AP), daughter artery ratio (DA), and lateral angle ratio (LA) have been reported in middle cerebral artery bifurcation aneurysms to correlate with rupture status. Objective To study the differences in AP, DA, LA, and aneurysm orientation between ruptured and unruptured basilar bifurcation aneurysms. Methods Three-dimensional (3D) angiograms of patients with basilar bifurcation aneurysms were analyzed for AP, DA, and LA. Aneurysm projection was classified as type A if the long axis of aneurysm was along basilar artery and type-B if otherwise. Results Thirty-one ruptured and 17 unruptured aneurysms were analyzed. The APs were significantly different (p = 0.008), 2.63 ± 1.1 for ruptured aneurysms and 1.7 ± 0.55 for unruptured aneurysms. AP ≥ 1.9 correlated with rupture status with 68% sensitivity and 70% specificity. Type-A configuration was significantly associated with ruptured aneurysms with an odds ratio (OR) of 5.9. LAs were 0.9 ± 0.4 and 1.4 ± 0.8 for ruptured and unruptured aneurysms, respectively, and the difference tended to be significant (p = 0.56). DAs were 1.25 ± 0.22 and 1.21 ± 0.19 for ruptured and unruptured aneurysms without any statistical difference. Conclusion AP > 1.9, type-A configuration, and lower LA is associated with ruptured basilar bifurcation aneurysms. DA did not differ between ruptured and unruptured aneurysms.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 92%

Morphological Differences between Ruptured and Unruptured Basilar Bifurcation Aneurysms

et al. 2013

View full text Add to dashboard Cite

show abstract

“…This is also confirmed by other studies reported in the literature. 26,27 One might question the applicability of the theory identified by this study to sidewall arteries. Indeed, asymmetric bifurcations present similar anatomies to sidewall arteries, albeit with much higher percentages of parent arteries in the follow-up because ophthalmic and anterior choroidal arteries do not seem to suffer the same clinical fate when covered by FDSs.…”

Section: Discussionmentioning

confidence: 94%

The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents

Narata

Moura

Larrabide

et al. 2017

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

Anatomic data analysis showed statistically significant correspondence between caliber changes and bifurcation asymmetry characterized by diameter ratio <0.7 ( < .001). Similarly, computational fluid dynamics results showed the highest impact on hemodynamics when flow-diverter stents are deployed in asymmetric bifurcations (diameter ratio <0.65) with noticeable changes on wall sheer stress fields. Further research and clinical validation are necessary to identify all elements involved in vessel caliber changes after flow-diverter stent procedures.

show abstract

“…However, the idealized models can be an over‐simplified representation of the underlying patient‐specific geometry, causing results to phenotypically differ from physiological flows. For example, turbulent‐like flow features in the internal carotid artery (ICA) is absent in idealized models because the ICA, a tortuous vessel with area variation, is approximated by a straight tube.…”

Section: Introductionmentioning

confidence: 99%

A framework for automated and objective modification of tubular structures: Application to the internal carotid artery

Bergersen

Kjeldsberg

Valen‐Sendstad

2020

Numer Methods Biomed Eng

View full text Add to dashboard Cite

Patient-specific medical image-based computational fluid dynamics has been widely used to reveal fundamental insight into mechanisms of cardiovascular disease, for instance, correlating morphology to adverse vascular remodeling.However, segmentation of medical images is laborious, error-prone, and a bottleneck in the development of large databases that are needed to capture the natural variability in morphology. Instead, idealized models, where morphological features are parameterized, have been used to investigate the correlation with flow features, but at the cost of limited understanding of the complexity of cardiovascular flows. To combine the advantages of both approaches, we developed a tool that preserves the patient-specificness inherent in medical images while allowing for parametric alteration of the morphology. In our opensource framework morphMan we convert the segmented surface to a Voronoi diagram, modify the diagram to change the morphological features of interest, and then convert back to a new surface. In this paper, we present algorithms for modifying bifurcation angles, location of branches, cross-sectional area, vessel curvature, shape of bends, and surface roughness. We show qualitative and quantitative validation of the algorithms, performing with an accuracy exceeding 97% in general, and proof-of-concept on combining the tool with computational fluid dynamics. By combining morphMan with appropriate clinical measurements, one could explore the morphological parameter space and resulting hemodynamic response using only a handful of segmented surfaces, effectively minimizing the main bottleneck in image-based computational fluid dynamics. K E Y W O R D S

show abstract

Effect of Bifurcation Angle Configuration and Ratio of Daughter Diameters on Hemodynamics of Bifurcation Aneurysms

Abstract: BACKGROUND AND PURPOSE: EL associated with ruptured aneurysms is higher than that for unruptured aneurysms. In this study, the effect of arterial morphologic variation of bifurcation aneurysms on EL was investigated in idealized models of middle cerebral artery aneurysms.

Cited by 27 publications

References 27 publications

Morphological Differences between Ruptured and Unruptured Basilar Bifurcation Aneurysms

Morphological Differences between Ruptured and Unruptured Basilar Bifurcation Aneurysms

The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents

A framework for automated and objective modification of tubular structures: Application to the internal carotid artery

Contact Info

Product

Resources

About