机构：[1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, Beijing重点科室医技科室研究所放射科放射科北京市神经外科研究所首都医科大学附属天坛医院[2]Departments of Neurosurgery,China-Japan Union Hospital, Jilin University, Changchun, China吉林大学中日联谊医院[3]Departments of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China吉林大学中日联谊医院
BACKGROUND: Hemodynamics plays an important role in aneurysm rupture. Microsurgical clipping provides the best chance to confirm the rupture point. The aim of this study was to explore the associations between the rupture point and hemodynamics. METHODS: Computational fluid dynamic simulations were performed on 16 intracranial aneurysms. The rupture point was detected at the time of clipping by 3 independent neurosurgeons. Hemodynamic parameters, including wall shear stress (WSS) and oscillatory shear index (OSI), were calculated at the rupture point and the whole aneurysm sac. Intra-aneurysmal flow patterns and flow impingement were also studied. RESULTS: The time-averaged WSS was 3.4855 +/- 3.8881 Pa at the aneurysm sac, which was significantly larger than that at the rupture point (1.5403 +/- 2.3688 Pa, P = 0.002). The OSI at the rupture point (0.0354 +/- 0.0459) was larger than at the sac (0.0220 +/- 0.0232) without difference. Thirteen aneurysms (81.3%) showed a complex flow pattern in the aneurysm sac; however, more than two thirds of the cases (68.7%) did not show a flow impact at the rupture point. Of these cases with daughter blebs, the rupture points were confirmed at the blebs in 6 cases. Two cases did not show association between blebs and rupture point. CONCLUSIONS: The hemodynamic characteristics at the rupture point were different from the aneurysm sac, and the WSS was significantly lower at the rupture point. Further study on the rupture risk assessment is still needed with more data and detailed information.
基金：
National Key Research Development Program [2016YFC1300800]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [816705049, 81371315, 81471167, 81220108007]; Special Research Project for Capital Health Development [2018-4-1077]
第一作者机构：[1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, Beijing[2]Departments of Neurosurgery,China-Japan Union Hospital, Jilin University, Changchun, China
通讯作者：
通讯机构：[1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, Beijing
推荐引用方式(GB/T 7714)：
Li Miao,Wang Jie,Liu Jian,et al.Hemodynamics in Ruptured Intracranial Aneurysms with Known Rupture Points[J].WORLD NEUROSURGERY.2018,118:E721-E726.doi:10.1016/j.wneu.2018.07.026.
APA：
Li, Miao,Wang, Jie,Liu, Jian,Zhao, Conghai&Yang, Xinjian.(2018).Hemodynamics in Ruptured Intracranial Aneurysms with Known Rupture Points.WORLD NEUROSURGERY,118,
MLA：
Li, Miao,et al."Hemodynamics in Ruptured Intracranial Aneurysms with Known Rupture Points".WORLD NEUROSURGERY 118.(2018):E721-E726
