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The Morphological and Hemodynamic Characteristics of the Intraoperative Ruptured Aneurysm

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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, [5]School of Life Sciences and Bioengineering, Beijing University of Technology, Beijing, China
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关键词: intraoperative aneurysm rupture hemodynamics morphology computational fluid dynamics aneurysm clipping

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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.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 3 区 神经科学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 神经科学
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出版当年[2017]版:
Q2 NEUROSCIENCES
最新[2023]版:
Q2 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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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,
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