Improved Evaluation of PCOM Aneurysms: Angio-Architecture, Hemodynamics and Shape

改进 PCOM 动脉瘤的评估：血管结构、血流动力学和形状

• 批准号: 9144876
• 负责人: Juan R Cebral
• 金额: $ 22.21万
• 依托单位: GEORGE MASON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9144876
• 关键词: Adult; Affect; Aneurysm; Architecture; Arteries; Benign; Categories; Cerebral Aneurysm; Characteristics; Clinical; Data; Descriptor; Development; Devices; Evaluation; Event; Face; Fundus; Future; Goals; Health; Health Care Costs; Internal carotid artery structure; Intervention; Intracranial Aneurysm; Knowledge; Location; Morbidity - disease rate; Neck; Operative Surgical Procedures; Outcome; Parents; Pathology; Patient Care; Patient Selection; Population; Procedures; Process; Relative Risks; Research; Risk; Risk Assessment; Risk Factors; Rupture; Ruptured Aneurysm; Safety; Secondary to; Shapes; Site; Statistical Data Interpretation; Structure of posterior communicating artery; Subarachnoid Hemorrhage; System; Testing; clinical decision-making; clinical practice; clinically relevant; design; hemodynamics; high risk; improved; indexing; middle cerebral artery; mortality; neurovascular; non-invasive imaging; research study; shear stress; tool

 DESCRIPTION (provided by applicant): Cerebral aneurysms affect a substantial fraction of the adult population and are increasingly detected with noninvasive imaging. Only a small fraction of aneurysms rupture, but subarachnoid hemorrhage secondary to aneurysm rupture is a devastating event that carries high rates of morbidity and mortality, and large healthcare costs. Although improving, endovascular and surgical interventions still carry significant risks that may exceed the natural rupture risk. Therefore, it is important to properly evaluate aneurysms to avoid unnecessary interventions of low risk aneurysms, and to identify high-risk aneurysms for immediate treatment. The most important predictors of aneurysm rupture according to past studies are size and location. However, it is well known that many small aneurysms do rupture. On the other hand, the posterior communicating artery (PCOM) is a common site for intracranial aneurysms and aneurysms at this location have larger risks than those at other locations. As such, clinicians often need to decide whether or not to treat PCOM aneurysms, but do not have other reliable parameters to guide and support their decisions. PCOM aneurysms have different angio- architectures (relationship of the aneurysm with respect to the parent artery). However, it is unknown whether aneurysms with different angio-architectures have different rupture rate. Our preliminary data suggests that they do. But, it remains unknown if ruptured or unruptured PCOM aneurysms with different angio-architectures have different hemodynamic and geometric features that explain the different rupture rate and distinguish "vulnerable" from "benign" aneurysms. The objectives of this project are to: 1) statistically confirm that PCOM aneurysms with different angio-architectural configurations have different rupture rates, 2) identify hemodynamic and geometric parameters that distinguish between ruptured and unruptured aneurysms of each architecture, and 3) provide clinicians with another tool in the armamentarium to face the neurovascular pathology, by developing a scoring scale for the rupture risk assessment of PCOM aneurysms. Clinical relevance of the proposed project: The results of this exploratory project will be applicable immediately to the clinical practice, and will be generalized and extended in future studies to other locations and aneurysm characteristics. Successful completion of this project will: 1) provide new knowledge to distinguish between vulnerable and benign PCOM aneurysms, 2) improve safety and outcome of aneurysm treatment by better patient selection, 3) advance our understanding of mechanisms responsible for aneurysm rupture, 4) guide future experiments and research, 5) guide development of procedures and devices. Each of these factors will contribute to the improvement of patient care.



项目成果

Development of a statistical model for discrimination of rupture status in posterior communicating artery aneurysms.

开发用于区分后交通动脉瘤破裂状态的统计模型。

• DOI: 10.1007/s00701-018-3595-8
• 发表时间: 2018-08
• 期刊: Acta neurochirurgica
• 影响因子: 2.4
• 作者: Detmer FJ;Chung BJ;Mut F;Pritz M;Slawski M;Hamzei-Sichani F;Kallmes D;Putman C;Jimenez C;Cebral JR
• 通讯作者: Cebral JR

External validation of cerebral aneurysm rupture probability model with data from two patient cohorts.

使用两个患者队列的数据对脑动脉瘤破裂概率模型进行外部验证。

• DOI: 10.1007/s00701-018-3712-8
• 发表时间: 2018
• 期刊: Acta neurochirurgica
• 影响因子: 2.4
• 作者: Detmer,FelicitasJ;Fajardo-Jiménez,Daniel;Mut,Fernando;Juchler,Norman;Hirsch,Sven;Pereira,VitorMendes;Bijlenga,Philippe;Cebral,JuanR
• 通讯作者: Cebral,JuanR

Development and internal validation of an aneurysm rupture probability model based on patient characteristics and aneurysm location, morphology, and hemodynamics.

• DOI: 10.1007/s11548-018-1837-0
• 发表时间: 2018-11
• 期刊: International journal of computer assisted radiology and surgery
• 影响因子: 3
• 作者: Detmer FJ;Chung BJ;Mut F;Slawski M;Hamzei-Sichani F;Putman C;Jiménez C;Cebral JR
• 通讯作者: Cebral JR

Angioarchitectures and Hemodynamic Characteristics of Posterior Communicating Artery Aneurysms and Their Association with Rupture Status.

• DOI: 10.3174/ajnr.a5358
• 发表时间: 2017-11
• 期刊: AJNR. American journal of neuroradiology
• 作者: Chung BJ;Doddasomayajula R;Mut F;Detmer F;Pritz MB;Hamzei-Sichani F;Brinjikji W;Kallmes DF;Jimenez CM;Putman CM;Cebral JR
• 通讯作者: Cebral JR

Identification of Hostile Hemodynamics and Geometries of Cerebral Aneurysms: A Case-Control Study.

• DOI: 10.3174/ajnr.a5764
• 发表时间: 2018-10
• 期刊: AJNR. American journal of neuroradiology
• 作者: Chung BJ;Mut F;Putman CM;Hamzei-Sichani F;Brinjikji W;Kallmes D;Jimenez CM;Cebral JR
• 通讯作者: Cebral JR