Flow instability detected in ruptured versus unruptured cerebral aneurysms at the internal carotid artery
Flow instability detected in ruptured versus unruptured cerebral aneurysms at the internal carotid artery
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DOI：
10.1016/j.jbiomech.2018.03.014
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发表时间：
2018-04-27
影响因子：
2.4
通讯作者：
Liu, Hao
中科院分区：
文献类型：
--
作者：
Xu, Lijian;Liang, Fuyou;Liu, Hao
血流不稳定性已成为一种新的血流动力学指标，假设在评估脑动脉瘤破裂风险方面具有潜在价值。然而，在文献中报告了不同的发现。在本研究中，对35个位于颈内动脉（伊卡）的动脉瘤（10个破裂和25个未破裂）进行了回顾性高分辨率血流动力学模拟。对破裂和未破裂动脉瘤的模拟血流动力学参数进行统计学比较，重点检查血流不稳定性与动脉瘤破裂状态的相关性。在20%（2/10）的破裂动脉瘤中检测到明显的血流不稳定，而在44%（11/25）的未破裂动脉瘤中检测到明显的血流不稳定。统计学上，破裂和未破裂动脉瘤之间的血流不稳定性指标（通过动脉瘤囊上的时间和空间平均波动动能量化）无显著差异。相反，低壁切应力面积（LSA）和压力损失系数（PLC）与动脉瘤破裂状态具有显著相关性。总之，本研究表明，血流不稳定性的存在可能与动脉瘤破裂的状态没有密切关系，至少对于伊卡动脉瘤。另一方面，研究的回顾性质和样本量小可能在一定程度上影响了结论的可靠性，因此需要进行大规模的前瞻性研究以进一步解决这个问题。(C)2018爱思唯尔有限公司版权所有
Flow instability has emerged as a new hemodynamic metric hypothesized to have potential value in assessing the rupture risk of cerebral aneurysms. However, diverse findings have been reported in the literature. In the present study, high-resolution hemodynamic simulations were performed retrospectively on 35 aneurysms (10 ruptured & 25 unruptured) located at the internal carotid artery (ICA). Simulated hemodynamic parameters were statistically compared between the ruptured and unruptured aneurysms, with emphasis on examining the correlation of flow instability with the status of aneurysm rupture. Pronounced flow instability was detected in 20% (2 out of 10) of the ruptured aneurysms, whereas in 44% (11 out of 25) of the unruptured aneurysms. Statistically, the flow instability metric (quantified by the temporally and spatially averaged fluctuating kinetic energy over the aneurysm sac) did not differ significantly between the ruptured and unruptured aneurysms. In contrast, low wall shear stress area (LSA) and pressure loss coefficient (PLC) exhibited significant correlations with the status of aneurysm rupture. In conclusion, the present study suggests that the presence of flow instability may not correlate closely with the status of aneurysm rupture, at least for ICA aneurysms. On the other hand, the retrospective nature of the study and the small sample size may have to some extent compromised the reliability of the conclusion, and therefore large-scale prospective studies would be needed to further address the issue. (C) 2018 Elsevier Ltd. All rights reserved.