Irregular Shape Identifies Ruptured Intracranial Aneurysm in Subarachnoid Hemorrhage Patients With Multiple Aneurysms

Abstract

Irregular shape may identify the ruptured sIA better than size in patients presenting with aSAH and multiple sIAs.

Morphological and numerical assessment of intracranial aneurysms ruptures risk

“…This form of aneurysm was described by Weir in 1987 [28]. In recent years, more and more researchers [4,8,11,16,22,23] point to the fact that ruptured aneurysms have irregular shape. From the mechanical point of view, wall of an aneurysm with inhomogeneities can have an inhomogeneous stress field, and structure of the flow inside such aneurysms becomes unstable and inhomogeneous.…”

“…Taking into account morphological factors that can be analyzed on the basis of 3D aneurysm models presented in this work, two of four considered aneurysms has a high risk of rupture (Table 4) [3,9,10,11,23,27].…”

“…The study was carried out using methods of computational fluid dynamics (CFD), which makes it possible to evaluate blood flow in aneurysms. [29] 2003 Size of aneurysm 7 mm and more -for ruptured [8] 2008 Size ratio 2.05 and more -for ruptured [23] 2010 Size ratio 2.57 -average for unruptured 4.08 -average for ruptured more than 3 -for ruptured [21] 2014 Size of aneurysm, irregular shape 9 mm and more -for ruptured [5] 2015 Size ratio 1.55 -average for unruptured 2.09 -average for ruptured [11] [20] 2017 Size of aneurysm 7 mm and more -for ruptured [10] 2017 Size of aneurysm between 5 and 10 mm -size of ruptured [25] 2017 Size of aneurysm Not availible [3] 2017 Size of aneurysm, irregular shape 2.5 mm -average for unruptured 6.9 mm -average for ruptured [9] 2017 Size ratio 2.1 and more -for ruptured [4] 2018 Size ratio Not availible [24] 2016 Size ratio, size of aneurysm Size ratio more than 1.5 -for ruptured [2] 2013 Size of aneurysm Aneurysms of the anterior communicating artery with 4 mm in diameter should be treated. Other aneurysms less than 7 mm in size have a small risk of rupture.…”

Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms

“…Previous studies have investigated the morphologic and hemodynamic differences between ruptured and unruptured aneurysms in patients with multiple IAs, mainly through regression analysis, which is more suitable for modeling event probabilities. 9,10,[12][13][14]37 In the current study, the ruptured aneurysm was identified by directly comparing the IAs within each patient. We noted that morphology outperformed hemodynamics in identifying ruptured IAs.…”

“…Several morphologic and hemodynamic parameters have been found to differ significantly between ruptured and unruptured aneurysm cohorts in patients with multiple IAs, albeit with conflicting findings. [9][10][11][12][13][14][15] These studies have generally relied on univariate and multivariate regression analyses of pooled data of ruptured and unruptured IAs. Although such methods model the general probability of aneurysm rupture, they are not tailored for identifying which aneurysm ruptured in patients with SAH with multiple aneurysms.…”