机构:[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[2]China National Clinical Research Center for Neurological Diseases, Beijing, China,[3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China,[4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China,[5]School of Life Sciences and Bioengineering, Beijing University of Technology, Beijing, China
Background and Objectives: Intraoperative aneurysm rupture (IOR) is a difficult event during the clipping process for intracranial aneurysms, and could result in a bad prognosis. Preoperative discrimination of aneurysms with high risk of IOR is vital for operators. The aim of this study was to explore the hemodynamic-morphological risk factors for the IOR. Methods: In the present study, patients admitted for unruptured IA from January 2012 to April 2018 were retrospectively reviewed. A propensity score matching was performed to match patients. The morphological features and the hemodynamic features were extracted. Differences in the morphologic and hemodynamic parameters were compared. Risk factors associated with IOR were explored. Subsequently, the hemodynamic characteristics in different rupture stages and different regions in IOR aneurysm were compared. Results: 96 cases of patients with aneurysms, were found by the matching process in each group. The statistically significant difference was found in the maximum length (L) (p = 0.041), maximum diameter of body (D) (p = 0.032), aspect ratio (AR) (p < 0.001), non-sphericity index (NSI) (p < 0.001), normalized wall shear stress maximum (NWSSm) (p < 0.001) and oscillatory shear index (OSI) (p < 0.001). A regression analysis demonstrated AR (OR = 7.03, p < 0.001), NWSSm (OR = 15.55, p = 0.014) and OSI (OR = 28.30, p < 0.001) as the independent risk factors for IOR. AR was much larger, and NWSSm and NWSSa were much lower for IAs that ruptured in early or predissection stage than those for IAs that ruptured in dissection stage or clip application stage. NWSSa and NWSSm in rupture area were both lower than those in adjacent area. Conclusion: AR, NWSSm, and OSI are considered three independent risk factors for intraoperative aneurysm rupture, which could serve as predictors. A selection of intervention methods for aneurysms with high AR, low NWSSm, and high OSI should carefully be considered.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81471210, 81671129]; Major special projects in the 13th five-year plan [2016YFC1301800]
第一作者机构:[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,[2]China National Clinical Research Center for Neurological Diseases, Beijing, China,[3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China,[4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China,
通讯作者:
通讯机构:[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,[2]China National Clinical Research Center for Neurological Diseases, Beijing, China,[3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China,[4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China,
推荐引用方式(GB/T 7714):
Qingyuan Liu,Pengjun Jiang,Jun Wu,et al.The Morphological and Hemodynamic Characteristics of the Intraoperative Ruptured Aneurysm[J].FRONTIERS IN NEUROSCIENCE.2019,13:-.doi:10.3389/fnins.2019.00233.
APA:
Qingyuan Liu,Pengjun Jiang,Jun Wu,Bin Gao&Shuo Wang.(2019).The Morphological and Hemodynamic Characteristics of the Intraoperative Ruptured Aneurysm.FRONTIERS IN NEUROSCIENCE,13,
MLA:
Qingyuan Liu,et al."The Morphological and Hemodynamic Characteristics of the Intraoperative Ruptured Aneurysm".FRONTIERS IN NEUROSCIENCE 13.(2019):-