Angioarchitectures and Hemodynamic Characteristics of Posterior Communicating Artery Aneurysms and Their Association with Rupture Status
| Autor: | Fernando Mut, Carlos Jimenez, David F. Kallmes, Juan R. Cebral, Bong Jae Chung, Farid Hamzei-Sichani, Christopher M. Putman, Waleed Brinjikji, Felicitas J. Detmer, Michael B. Pritz, Ravi Doddasomayajula |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Hemodynamics Parent artery Posterior Communicating Artery Aneurysm Aneurysm Ruptured Article 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm Risk Factors medicine.artery Internal medicine medicine Shear stress Humans Radiology Nuclear Medicine and imaging Rupture risk cardiovascular diseases Posterior communicating artery business.industry Intracranial Aneurysm Flow pattern medicine.disease Hydrodynamics cardiovascular system Cardiology Stress Mechanical Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | American Journal of Neuroradiology. 38:2111-2118 |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a5358 |
| Popis: | BACKGROUND AND PURPOSE: Intracranial aneurysms originating at the posterior communicating artery are known to have high rupture risk compared with other locations. We tested the hypothesis that different angioarchitectures (ie, branch point configuration) of posterior communicating artery aneurysms are associated with aneurysm hemodynamics, which in turn predisposes aneurysms to rupture. MATERIALS AND METHODS: A total of 313 posterior communicating artery aneurysms (145 ruptured, 168 unruptured) were studied with image-based computational fluid dynamics. Aneurysms were classified into different angioarchitecture types depending on the location of the aneurysm with respect to parent artery bifurcation. Hemodynamic characteristics were compared between ruptured and unruptured aneurysms, as well as among aneurysms with different angioarchitectures. RESULTS: Angioarchitecture was associated with rupture ( P = .003). Ruptured aneurysms had higher, more concentrated, and more oscillatory wall shear stress distributions (maximum wall shear stress, P P P P = .01; inflow concentration index, P P P P = .02) and minimum wall shear stress ( P = .002) than unruptured aneurysms. CONCLUSIONS: High-flow intrasaccular hemodynamic characteristics, commonly found in bifurcation-type angioarchitectures, are associated with the posterior communicating artery aneurysm rupture status. These characteristics include strong and concentrated inflow jets, concentrated regions of elevated wall shear stress, oscillatory wall shear stress, lower normalized wall shear stress, and complex and unstable flow patterns. |
| Databáze: | OpenAIRE |
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