Differences Between Ruptured Aneurysms With and Without Blebs: Mechanistic Implications.
Differences Between Ruptured Aneurysms With and Without Blebs: Mechanistic Implications.
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DOI：
10.1007/s13239-022-00640-4
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发表时间：
2023-02
影响因子：
1.8
通讯作者：
Cebral, Juan R.
中科院分区：
文献类型：
--
作者：
Ashkezari, Seyedeh Fatemeh Salimi;Mut, Fernando;Robertson, Anne M.;Cebral, Juan R.
气泡是颅内动脉瘤 (IA) 破裂的已知危险因素。我们分析了带有气泡破裂的 IAs 和不产生气泡而破裂的 IAs 之间的差异。使用基于图像的模型，比较了有或没有气泡的破裂 IAs 之间的 25 个血流动力学和几何参数 (n=673)，并按位置分层。还分析了分叉和侧壁动脉瘤之间以及五个位置的动脉瘤的血流动力学和几何差异。含有气泡的破裂动脉瘤比没有形成气泡的破裂动脉瘤暴露在更高的流量条件下，并且这在不同位置是一致的。分叉动脉瘤暴露于比侧壁动脉瘤更高的流量条件。与侧壁动脉瘤相比，它们具有更大的最大壁剪切应力（WSS）、更集中的WSS分布以及更多的临界点。此外，分叉动脉瘤比侧壁动脉瘤更大、更细长、形状更扭曲。动脉瘤形态与动脉瘤位置相关（p<0.01）。动脉瘤位置之间的血流条件不同。不同位置的动脉瘤可能发展成不同的形态，因此暴露于不同的血流条件下，这可能使它们倾向于遵循不同的破裂路径，无论是否有气泡形成。这可以解释不同位置动脉瘤中不同的破裂率和气泡存在。
Blebs are known risk factors for intracranial aneurysm (IA) rupture. We analyzed differences between IAs that ruptured with blebs and those that ruptured without developing blebs. Using image-based models, 25 hemodynamic and geometric parameters were compared between ruptured IAs with and without blebs (n=673), stratified by location. Hemodynamic and geometric differences between bifurcation and sidewall aneurysms and for aneurysms at five locations were also analyzed. Ruptured aneurysms harboring blebs were exposed to higher flow conditions than aneurysms that ruptured without developing blebs, and this was consistent across locations. Bifurcation aneurysms were exposed to higher flow conditions than sidewall aneurysms. They had larger maximum wall shear stress (WSS), more concentrated WSS distribution, and larger numbers of critical points than sidewall aneurysms. Additionally, bifurcation aneurysms were larger, more elongated, and had more distorted shapes than sidewall aneurysms. Aneurysm morphology was associated with aneurysm location (p<0.01). Flow conditions were different between aneurysm locations. Aneurysms at different locations are likely to develop into varying morphologies and thus be exposed to diverse flow conditions that may predispose them to follow distinct pathways towards rupture with or without bleb development. This could explain the diverse rupture rates and bleb presence in aneurysms at different locations.
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影响因子：
3.2
作者：
Durka MJ;Wong IH;Kallmes DF;Pasalic D;Mut F;Jagani M;Blanco PJ;Cebral JR;Robertson AM
通讯作者：
Robertson AM
影响因子：
3.8
作者：
Robertson AM;Duan X;Aziz KM;Hill MR;Watkins SC;Cebral JR
通讯作者：
Cebral JR
影响因子：
8.3
作者：
Murayama, Yuichi;Takao, Hiroyuki;Molyneux, Andrew J.
通讯作者：
Molyneux, Andrew J.
影响因子：
8.3
作者：
Lindgren, Antti E.;Koivisto, Timo;Frosen, Juhana
通讯作者：
Frosen, Juhana
影响因子：
2
作者：
Li, Miao;Wang, Jie;Yang, Xinjian
通讯作者：
Yang, Xinjian