Intracranial Fusiform Aneurysms: It's Pathogenesis, Clinical Characteristics and Managements

BACKGROUND AND PURPOSE:Treatment of giant fusiform aneurysms with flow diverters has been associated with a relatively high rate of complications. Our goal was to study the evolution of flow-diverter endothelialization and thrombus organization at different time points after flow-diverter treatment in giant fusiform aneurysms to better understand reasons for flow-diverter thrombosis and delayed aneurysm ruptures.

show abstract

“…11 Their etiology is unclear; both atherosclerosis and dissection have been proposed as pathogenetic factors.…”

Section: Discussionmentioning

confidence: 99%

Evolution of Flow-Diverter Endothelialization and Thrombus Organization in Giant Fusiform Aneurysms after Flow Diversion: A Histopathologic Study

Szikora

Turányi

Marosfői

2015

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…The pathogenesis of fusiform aneurysms, with some exceptions, 26 is closely related to atherosclerosis. 27 Because a vast majority (Ͼ80%) of intracranial aneurysms are saccular, 28 we will focus our discussion on this type of aneurysm.…”

Section: Relationship Between Hemodynamics and Aneurysm Developmentmentioning

confidence: 99%

High WSS or Low WSS? Complex Interactions of Hemodynamics with Intracranial Aneurysm Initiation, Growth, and Rupture: Toward a Unifying Hypothesis

Meng

Tutino

Xiang

et al. 2013

AJNR Am J Neuroradiol

719

590

View full text Add to dashboard Cite

SUMMARY:Increasing detection of unruptured intracranial aneurysms, catastrophic outcomes from subarachnoid hemorrhage, and risks and cost of treatment necessitate defining objective predictive parameters of aneurysm rupture risk. Image-based computational fluid dynamics models have suggested associations between hemodynamics and intracranial aneurysm rupture, albeit with conflicting findings regarding wall shear stress. We propose that the "high-versus-low wall shear stress" controversy is a manifestation of the complexity of aneurysm pathophysiology, and both high and low wall shear stress can drive intracranial aneurysm growth and rupture. Low wall shear stress and high oscillatory shear index trigger an inflammatory-cell-mediated pathway, which could be associated with the growth and rupture of large, atherosclerotic aneurysm phenotypes, while high wall shear stress combined with a positive wall shear stress gradient trigger a mural-cell-mediated pathway, which could be associated with the growth and rupture of small or secondary bleb aneurysm phenotypes. This hypothesis correlates disparate intracranial aneurysm pathophysiology with the results of computational fluid dynamics in search of more reliable risk predictors. ABBREVIATIONS:CFD ϭ computational fluid dynamics; ECM ϭ extracellular matrix; WSS ϭ wall shear stress

show abstract

“…It has been suggested that the initial event in formation of a fusiform aneurysm is lipid deposition in and below the intima leading to disruption of the internal elastic membrane and infiltration of the muscular wall [5,13]. The resultant atrophy of the elastic substance and musculature then leads to tortuosity of the vessel due to intravascular pressure causing the ectatic vessel to expand in diameter and length.…”

Section: Discussionmentioning

confidence: 99%

“…As previously mentioned, our patient had a long history of hypertension. Proposed etiologic factors of fusiform aneurysms include atherosclerosis, vessel dissection, collagen vascular disease, and fibromuscular dysplasia [13].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multiple cerebral fusiform aneurysms involving the posterior and anterior circulation including the anterior cerebral artery: a case report

Das¹,

Vályi-Nagy²

2017

View full text Add to dashboard Cite

show abstract

Intracranial Fusiform Aneurysms: It's Pathogenesis, Clinical Characteristics and Managements

Cited by 107 publications

References 34 publications

Evolution of Flow-Diverter Endothelialization and Thrombus Organization in Giant Fusiform Aneurysms after Flow Diversion: A Histopathologic Study

Evolution of Flow-Diverter Endothelialization and Thrombus Organization in Giant Fusiform Aneurysms after Flow Diversion: A Histopathologic Study

High WSS or Low WSS? Complex Interactions of Hemodynamics with Intracranial Aneurysm Initiation, Growth, and Rupture: Toward a Unifying Hypothesis

Multiple cerebral fusiform aneurysms involving the posterior and anterior circulation including the anterior cerebral artery: a case report

Contact Info

Product

Resources

About