J 2024

Rupture point is associated with divergent hemodynamics in intracranial aneurysms

HEJCL, Ales, Jana BRUNATOVA, Helena SVIHLOVA, Jan VÍTEČEK, Andrea VÍTEČKOVÁ WÜNSCHOVÁ et. al.

Basic information

Original name

Rupture point is associated with divergent hemodynamics in intracranial aneurysms

Authors

HEJCL, Ales (203 Czech Republic), Jana BRUNATOVA (203 Czech Republic), Helena SVIHLOVA (203 Czech Republic), Jan VÍTEČEK (203 Czech Republic, belonging to the institution), Andrea VÍTEČKOVÁ WÜNSCHOVÁ (203 Czech Republic, belonging to the institution), Alena SEJKOROVA (203 Czech Republic), Maria HUNDZA STRATILOVA (203 Czech Republic), Tomas RADOVNICKY (203 Czech Republic), Martin SAMES (203 Czech Republic) and Jaroslav HRON (203 Czech Republic)

Edition

Frontiers in Neurology, Lausanne, Frontiers, 2024, 1664-2295

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.400 in 2022

Organization unit

Faculty of Medicine

UT WoS

001237269700001

Keywords in English

intracranial aneurysm; computational fluid dynamics; rupture; particle image velocimetry (PIV); wall shear stress (WSS)

Tags

International impact, Reviewed
Změněno: 10/6/2024 12:14, Mgr. Tereza Miškechová

Abstract

V originále

Background Understanding the risk factors leading to intracranial aneurysm (IA) rupture have still not been fully clarified. They are vital for proper medical guidance of patients harboring unruptured IAs. Clarifying the hemodynamics associated with the point of rupture could help could provide useful information about some of the risk factors. Thus far, few studies have studied this issue with often diverging conclusions.Methods We identified a point of rupture in patients operated for an IAs during surgery, using a combination of preoperative computed tomography (CT) and computed tomography angiography (CTA). Hemodynamic parameters were calculated both for the aneurysm sac as a whole and the point of rupture. In two cases, the results of CFD were compared with those of the experiment using particle image velocimetry (PIV).Results We were able to identify 6 aneurysms with a well-demarcated point of rupture. In four aneurysms, the rupture point was near the vortex with low wall shear stress (WSS) and high oscillatory shear index (OSI). In one case, the rupture point was in the flow jet with high WSS. In the last case, the rupture point was in the significant bleb and no specific hemodynamic parameters were found. The CFD results were verified in the PIV part of the study.Conclusion Our study shows that different hemodynamic scenarios are associated with the site of IA rupture. The numerical simulations were confirmed by laboratory models. This study further supports the hypothesis that various pathological pathways may lead to aneurysm wall damage resulting in its rupture.

Links

NU22-08-00124, research and development project
Name: Modelování toku v intrakraniálních cévách ve vztahu ke změnám endotelu a rozvoji intrakraniálních aneuryzmat
Investor: Ministry of Health of the CR, Subprogram 1 - standard