Analysis of Morphologic and Hemodynamic Parameters for Unruptured Posterior Communicating Artery Aneurysms with Oculomotor Nerve Palsy

Yu, Ying; Xu, Jianrong; Fang, Yibin; Wu, Xiaoxuan; Yang, Pengfei; Che, Jing; Qian, Yi; Liu, J.; Huang, Qinghai

doi:10.3174/ajnr.a3575

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…In a previous hemodynamic study on mirror PcomA aneurysms, we also showed that, compared with unruptured aneurysms, ruptured aneurysms have a lower WSS and a larger low WSS area 4. In another study11 we observed that unruptured PcomA aneurysms with oculomotor nerve palsy have lower WSS than ruptured aneurysms. Hence, oculomotor nerve palsy is a clinical symptom of the sudden increase in the PcomA aneurysm sac, and PcomA aneurysms with oculomotor nerve palsy have a higher risk of rupture.…”

Section: Discussionsupporting

confidence: 50%

Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case–control study

Duan

Yin

et al. 2014

J NeuroIntervent Surg

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Section: Discussionsupporting

confidence: 50%

Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case–control study

Duan

Yin

et al. 2014

J NeuroIntervent Surg

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“…Researchers performed morphological–hemodynamic analysis on matched pairs of ruptured/unruptured mirror or symptomatic PCoA aneurysms and found correlations between some hemodynamic factors and PCoA aneurysm rupture 12 13. This is encouraging and promising, but the findings are limited by very small sample sizes and lack of analysis of clinical characteristics.…”

Section: Introductionmentioning

confidence: 99%

Clinical, morphological, and hemodynamic independent characteristic factors for rupture of posterior communicating artery aneurysms

Zhang

Jing

Liu

et al. 2015

J NeuroIntervent Surg

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“…More and more published CFD studies seem to suggest that high WSS results in intracranial aneurysm growth and low WSS in rupture. 7,12,14,15,18,19,22,24,25,27 However, these results were inconsistent with those obtained by Liu et al and Yu et al 13,26,30,34 They found high WSS in the ruptured aneurysm group. Moreover, it is important to note that their average WSS in the aneurysm region (1.64 ± 1.16 N/m 2 ) was significantly lower than that observed in the vessel region (p < 0.05), which highly accords with our findings.…”

Section: Discussionmentioning

confidence: 70%

High wall shear stress beyond a certain range in the parent artery could predict the risk of anterior communicating artery aneurysm rupture at follow-up

Zhang

Tamrakar

Yao

et al. 2019

Journal of Neurosurgery

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OBJECTIVEAmong clinical and morphological criteria, hemodynamics is the main predictor of aneurysm growth and rupture. This study aimed to identify which hemodynamic parameter in the parent artery could independently predict the rupture of anterior communicating artery (ACoA) aneurysms by using multivariate logistic regression and two-piecewise linear regression models. An additional objective was to look for a more simplified and convenient alternative to the widely used computational fluid dynamics (CFD) techniques to detect wall shear stress (WSS) as a screening tool for predicting the risk of aneurysm rupture during the follow-up of patients who did not undergo embolization or surgery.METHODSOne hundred sixty-two patients harboring ACoA aneurysms (130 ruptured and 32 unruptured) confirmed by 3D digital subtraction angiography at three centers were selected for this study. Morphological and hemodynamic parameters were evaluated for significance with respect to aneurysm rupture. Local hemodynamic parameters were obtained by MR angiography and transcranial color-coded duplex sonography to calculate WSS magnitude. Multivariate logistic regression and a two-piecewise linear regression analysis were performed to identify which hemodynamic parameter independently characterizes the rupture status of ACoA aneurysms.RESULTSUnivariate analysis showed that WSS (p < 0.001), circumferential wall tension (p = 0.005), age (p < 0.001), the angle between the A1 and A2 segments of the anterior cerebral artery (p < 0.001), size ratio (p = 0.023), aneurysm angle (p < 0.001), irregular shape (p = 0.005), and hypertension (grade II) (p = 0.006) were significant parameters. Multivariate analyses showed significant association between WSS in the parent artery and ACoA aneurysm rupture (p = 0.0001). WSS magnitude, evaluated by a two-piecewise linear regression model, was significantly correlated with the rupture of the ACoA aneurysm when the magnitude was higher than 12.3 dyne/cm2 (HR 7.2, 95% CI 1.5–33.6, p = 0.013).CONCLUSIONSWSS in the parent artery may be one of the reliable hemodynamic parameters characterizing the rupture status of ACoA aneurysms when the WSS magnitude is higher than 12.3 dyne/cm2. Analysis showed that with each additional unit of WSS (even with a 1-unit increase of WSS), there was a 6.2-fold increase in the risk of rupture for ACoA aneurysms.

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Analysis of Morphologic and Hemodynamic Parameters for Unruptured Posterior Communicating Artery Aneurysms with Oculomotor Nerve Palsy

Cited by 7 publications

References 25 publications

Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case–control study

Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case–control study

Clinical, morphological, and hemodynamic independent characteristic factors for rupture of posterior communicating artery aneurysms

High wall shear stress beyond a certain range in the parent artery could predict the risk of anterior communicating artery aneurysm rupture at follow-up

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