Is the Aspect Ratio a Reliable Index for Predicting the Rupture of a Saccular Aneurysm?

Ujiié, Hiroshi; Tamano, Yoshinori; Sasaki, Kuri; Hori, Tomokatsu

doi:10.1097/00006123-200103000-00007

Cited by 367 publications

(299 citation statements)

References 38 publications

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“…For example, researchers have found that certain aneurysm shapes are risk factors that may associate aneurysm morphology with rupture. [2][3][4] By analyzing blood flow properties in groups of ruptured and unruptured aneurysms, reports have also shown that certain hemodynamic factors may play an important role in aneurysm rupture. [5][6][7][8][9] However, the morphologic and hemodynamic risk factors analyzed in these studies have generally been identified by analyzing ruptured aneurysms after rupture.…”

mentioning

confidence: 99%

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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mentioning

confidence: 99%

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

Chien¹,

Sayre

2014

AJNR Am J Neuroradiol

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“…It does not find unruptured aneurysms with AR <1. In unruptured aneurysms, AR is 90% smaller than 1.6, and with ruptured AR > 1.6 is present in 79% of the ACA, 58% MCA, 85% ACII and 81% in other locations (29). According to Taman and associates unruptured aneurysms with AR> 1.6 are under high risk of rupture in the near future from the moment of diagnosis (25).…”

Section: Discussionmentioning

confidence: 99%

“…In this series of ruptured aneurysms AR> 1.6 was found in up to 84.71% and unruptured in only 9.68%. This indicates that AR is a good predictive factor for predisposing rupture (29). Blood flow is turbulent and may lead to cell migration of the muscular middle layer of the vessel wall, which activates the enzyme matrix metalloproteinase (MMPs) and other proteolytic enzymes causing the degeneration and thinning the wall of the aneurysm (10,16,28).…”

Section: Discussionmentioning

confidence: 99%

“…In regards to the relative ratios, the Aspect Ratio (AR) was examined, i.e. the ratio between the maximum height of the aneurysm and the diameter of the aneurysm neck (8,28,29). The fact that it was not possible to assess topometric parameters of the blood vessel and their ratio in an aneurysm was a limiting factor in their study.…”

Section: Nikolic I Et Al: Morphometric Parameters For Rupture Of Intmentioning

confidence: 99%

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Predictible morfometric parameters for ruptrue of intracranial aneurysms – series of 142 operated aneurysms

Nikolić

Tasić²,

Bogosavljevic³

et al. 2011

Turkish Neurosurgery

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AIM: Intracranial aneurysm rupture is followed by high mortality and morbidity. In order to understand the aneurysm's natural course, it is necessary to recognize the predisposing factors for the rupture. ResULTs:The ratio between the width of the aneurysm neck and diameter of the carrying blood vessel -artery in ruptured aneurysms (OR) was 1.58±0.61, and in unruptured aneurysms 1.14±0.52 (p<0.01). Aspect ratio of ruptured aneurysm was 1.89 ± 0.59, and in unruptured 1:33 ± 0.17. The angle of inclination of ruptured aneurysms was 139.22 ± 21.53, while in unruptured aneurysms it was 101.73 ± 21.26. CoNCLUsIoN:Based on the results of our research, a predictive model of morphometric characteristics of the vessel bearing the aneurysm to rupture can be identified: an irregular shape of the aneurysm, AR> 1.6, OR> 1.5 and inclination angle >135 deg. soNUÇ: Araştırmamızın sonuçları temelinde rüptüre olacak anevrizmayı taşıyan damarın morfometrik özelliklerinin prediktif bir modeli tanımlanabilir: Anevrizmada düzensiz şekil, aspekt oranı >1,6, OR >1,5 ve inklinasyon açısı >135 derece.

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“…It has been empirically found that the size of aneurysms is a reliable anatomical factor predictive of rupture, and statistics have been compiled regarding the size of ruptured and unruptured aneurysms. 27,29 For example, Ujiie et al suggested that the aspect ratio of aneurysms is a useful parameter in predicting imminent aneurysmal rupture. 29 Although hemodynamic forces such as blood pressure and wall shear stress due to blood flow are known to be related to the development, progress, and rupture of aneurysms, 2,7,14,25 detailed mechanisms remain to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

Fundamental Study of Ultrasonic-Measurement-Integrated Simulation of Real Blood Flow in the Aorta

et al. 2005

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Abstract-Acquisition of detailed information on the velocity and pressure fields of the blood flow is essential to achieve accurate diagnosis or treatment for serious circulatory diseases such as aortic aneurysms. A possible way to obtain such information is integration of numerical simulation and color Doppler ultrasonography in the framework of a flow observer. This methodology, namely, Ultrasonic-Measurement-Integrated (UMI) Simulation, consists of the following processes. At each time step of numerical simulation, the difference between the measurable output signal and the signal indicated by numerical simulation is evaluated. Feedback signals are generated from the difference, and numerical simulation is updated applying the feedback signal to compensate for the difference. This paper deals with a numerical study on the fundamental characteristics of UMI simulation using a simple two-dimensional model problem for the blood flow in an aorta with an aneurysm. The effect of the number of feedback points and the feedback formula are investigated systematically. It is revealed that the result of UMI simulation in the feedback domain rapidly converges to the standard solution, even with usually inevitable incorrect upstream boundary conditions. Finally, an example of UMI simulation with feedback from real color Doppler measurement also shows a good agreement with measurement.

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Is the Aspect Ratio a Reliable Index for Predicting the Rupture of a Saccular Aneurysm?

Cited by 367 publications

References 38 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

Predictible morfometric parameters for ruptrue of intracranial aneurysms – series of 142 operated aneurysms

Fundamental Study of Ultrasonic-Measurement-Integrated Simulation of Real Blood Flow in the Aorta

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