Changes in wall shear stress magnitude after aneurysm rupture

Abstract

Computational fluid dynamics (CFD) studies on cerebral aneurysms have attempted to identify surrogate hemodynamic parameters to predict rupture risk. We present a case of bilateral mirror image aneurysms, one of which ruptured soon after imaging. Wall shear stress values of the ruptured aneurysm changed by 20-30% after rupture because of change in the aneurysm shape. Findings from our case suggest that CFD studies comparing unruptured and ruptured aneurysms may not yield valid estimation on aneurysm rupture risk because of changes in aneurysm shape after rupture. Changes in aneurysm shape after rupture should be considered in CFD research.

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

“…23 Our data showed that changes in aneurysm shape are not restricted to low WSS regions. As previously reported by Kono et al 24 in a study of a single posterior communicating artery aneurysm, we also found WSS changes before and after rupture. The present study of 4 ruptured aneurysms provides the first comparative data in individual aneurysms before and after rupture showing that WSS may change.…”

Hemodynamic characteristics of large unruptured internal carotid artery aneurysms prior to rupture: a case control study

“…Evidence showed that the simulation results were altered by the morphologic changes of the IAs after rupture 9 10. In the current study, we compared hemodynamic parameters between pre-ruptured and unruptured (controls) aneurysm models.…”

“…There are only a few studies on the hemodynamic characteristics of IAs just before rupture, and most are single case reports. Furthermore, the results are not consistent 9 11–14…”

“…Morphological changes after aneurysm rupture, which leads to alteration in hemodynamic features, may be one reason. Some researchers believe that results based on post-ruptured geometric models may not be valid 9 10. To understand the association between IA rupture and hemodynamic factors, it is important to demonstrate the hemodynamic characteristics of IAs just before rupture.…”

RETRACTED: Hemodynamic Features of Unruptured Cerebral Aneurysms before Rupture: A CFD Study

“…Morphological features of aneurysms were effective and reproducible to treatment decision [17]. Irregular shape or blebs were strongly suggested to treatment, even for those unruptured aneurysms.…”