Wall shear stress association with rupture status in volume matched sidewall aneurysms

Lauric, Alexandra; Hippelheuser, James; Cohen, Alex D.; Kadasi, Laith M; Malek, Adel M.

doi:10.1136/neurintsurg-2013-010871

Cited by 25 publications

(14 citation statements)

References 29 publications

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“…While the main characteristics of the flow (as depicted by velocity profiles and streamlines) are maintained between modality/reconstruction models, there are subtle but important differences. It is evident from the TAWSS histograms (figure 2B) that the WSS distribution varies between models, with dramatic impact on the lower WSS range which has been proposed as predictive in rupture status classification 14. This was true for all aneurysms evaluated in this study.…”

Section: Resultsmentioning

confidence: 53%

Critical role of angiographic acquisition modality and reconstruction on morphometric and haemodynamic analysis of intracranial aneurysms

Lauric

Hippelheuser

Malek

2018

J NeuroIntervent Surg

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Section: Resultsmentioning

confidence: 53%

Critical role of angiographic acquisition modality and reconstruction on morphometric and haemodynamic analysis of intracranial aneurysms

Lauric

Hippelheuser

Malek

2018

J NeuroIntervent Surg

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“…One reason for controversy might be that most studies simulated a full-range of aneurysm size in the sample studied. For example, it was reported that aneurysm size was a confounding factor in WSS rupture discrimination (2, 9). Thus, some studies eliminated the confounding effect of aneurysm size using size-match analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, hemodynamic results are conflicting as both low and high WSS were reported to be associated with rupture status. Evidence shows that combined samples, including different sizes of aneurysm, might influence hemodynamic results in the assessment of rupture status, with larger aneurysms usually being characterized with low WSS (9, 10). The confounding effect of size should be controlled in the analysis of rupture status of aneurysms.…”

Section: Introductionmentioning

confidence: 99%

Bifurcation Type and Larger Low Shear Area Are Associated with Rupture Status of Very Small Intracranial Aneurysms

et al. 2016

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BackgroundCharacterization of the risk factors for rupture of very small intracranial aneurysm (VSIA, ≤3 mm) is clinically valuable, since VSIAs are implicated in subarachnoid hemorrhage. The aim of this study was to identify morphological and hemodynamic parameters that independently characterize the rupture status of VSIAs.MethodsWe conducted a retrospective study of consecutive VSIAs between September 2010 and February 2014 in our institute. A series of morphologic and hemodynamic parameters were evaluated using computational fluid dynamics, based on patient-specific three-dimensional geometrical models.ResultsWe identified 186 patients with 206 VSIAs (73 ruptured, 133 unruptured). Univariable logistic regression analysis showed that bifurcation type, parent artery diameter, size ratio, time-averaged wall shear stress (WSS), maximum WSS, minimum WSS, and low shear area (LSA) were related to rupture status. Bifurcation type and larger LSA were independently associated with rupture status in multivariable logistic regression (p = 0.002 and p = 0.003, respectively).ConclusionBifurcation type and larger LSA were independently associated with VSIA rupture status. Further studies are needed prospectively on patient-derived geometries prior to rupturing based on large multi-population data to confirm the present findings.

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“…For example, for anterior aneurysms, the MWSS of ruptured aneurysm ranged from 10.76 Pa25 to 55.64 Pa19 between studies, a variation of more than 400%. This is likely due to a combination of methodology and patient-to-patient variations.…”

Section: Data Analysis and Synthesismentioning

confidence: 99%

Towards the Clinical utility of CFD for assessment of intracranial aneurysm rupture – a systematic review and novel parameter-ranking tool

Liang

Steinman

Brina

et al. 2018

J NeuroIntervent Surg

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BackgroundIntracranial aneurysms (IAs) are vascular dilations on cerebral vessels that affect between 1%–5% of the general population, and can cause life-threatening intracranial hemorrhage when ruptured. Computational fluid dynamics (CFD) has emerged as a promising tool to study IAs in recent years, particularly for rupture risk assessment. However, despite dozens of studies, CFD is still far from clinical use due to large variations and frequent contradictions in hemodynamic results between studies.PurposeTo identify key gaps in the field of CFD for the study of IA rupture, and to devise a novel tool to rank parameters based on potential clinical utility.MethodsA Pubmed search identified 231 CFD studies for IAs. Forty-six studies fit our inclusion criteria, with a total of 2791 aneurysms. For included studies, study type, boundary conditions, solver resolutions, parameter definitions, geometric and hemodynamic parameters used, and results found were recorded.Data synthesisAspect ratio, aneurysm size, low wall shear stress area, average wall shear stress, and size ratio were the parameters that correlate most strongly with IA rupture.LimitationsSignificant differences in parameter definitions, solver spatial and temporal resolutions, number of cycles between studies as well as frequently missing information such as inlet flow rates were identified. A greater emphasis on prospective studies is also needed.ConclusionsOur recommendations will help increase standardization and bridge the gaps in the CFD community, and expedite the process of making CFD clinically useful in guiding the treatment of IAs.

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Wall shear stress association with rupture status in volume matched sidewall aneurysms

Cited by 25 publications

References 29 publications

Critical role of angiographic acquisition modality and reconstruction on morphometric and haemodynamic analysis of intracranial aneurysms

Critical role of angiographic acquisition modality and reconstruction on morphometric and haemodynamic analysis of intracranial aneurysms

Bifurcation Type and Larger Low Shear Area Are Associated with Rupture Status of Very Small Intracranial Aneurysms

Towards the Clinical utility of CFD for assessment of intracranial aneurysm rupture – a systematic review and novel parameter-ranking tool

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