Wall shear stress gradient is independently associated with middle cerebral artery aneurysm development: a case-control CFD patient-specific study based on 77 patients
| العنوان: | Wall shear stress gradient is independently associated with middle cerebral artery aneurysm development: a case-control CFD patient-specific study based on 77 patients |
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| المؤلفون: | Anna Hebda, Wojciech Kaspera, Mikołaj Zimny, Wojciech Wolański, Edyta Kawlewska, Piotr Ładziński |
| المصدر: | BMC Neurology BMC Neurology, Vol 21, Iss 1, Pp 1-10 (2021) |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Ultrasonography, Doppler, Transcranial, Hemodynamics, Middle cerebral artery, Computational fluid dynamics, Wall shear stress, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Aneurysm formation, Wall shear stress gradient, Models, Cardiovascular, General Medicine, Patient specific, Middle Aged, Cardiology, cardiovascular system, Female, Blood Flow Velocity, circulatory and respiratory physiology, Adult, medicine.medical_specialty, 03 medical and health sciences, Oscillatory shear, Middle cerebral artery aneurysm, Young Adult, Aneurysm, Internal medicine, medicine.artery, Shear stress, Humans, Computer Simulation, RC346-429, Aged, Haemodynamics, business.industry, Research, Intracranial Aneurysm, medicine.disease, Case-Control Studies, Intracranial aneurysm formation, Neurology (clinical), Neurology. Diseases of the nervous system, Endothelium, Vascular, Stress, Mechanical, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery |
| الوصف: | Background Previously published computational fluid dynamics (CFD) studies regarding intracranial aneurysm (IA) formation present conflicting results. Our study analysed the involvement of the combination of high wall shear stress (WSS) and a positive WSS gradient (WSSG) in IA formation. Methods We designed a case-control study with a selection of 38 patients with an unruptured middle cerebral artery (MCA) aneurysm and 39 non-aneurysmal controls to determine the involvement of WSS, oscillatory shear index (OSI), the WSSG and its absolute value (absWSSG) in aneurysm formation based on patient-specific CFD simulations using velocity profiles obtained from transcranial colour-coded sonography. Results Among the analysed parameters, only the WSSG had significantly higher values compared to the controls (11.05 vs − 14.76 [Pa/mm], P = 0.020). The WSS, absWSSG and OSI values were not significantly different between the analysed groups. Logistic regression analysis identified WSS and WSSG as significant co-predictors for MCA aneurysm formation, but only the WSSG turned out to be a significant independent prognosticator (OR: 1.009; 95% CI: 1.001–1.017; P = 0.025). Significantly more patients (23/38) in the case group had haemodynamic regions of high WSS combined with a positive WSSG near the bifurcation apex, while in the control group, high WSS was usually accompanied by a negative WSSG (14/39). From the analysis of the ROC curve for WSSG, the area under the curve (AUC) was 0.654, with the optimal cut-off value −0.37 Pa/mm. The largest AUC was recognised for combined WSS and WSSG (AUC = 0.671). Our data confirmed that aneurysms tend to form near the bifurcation apices in regions of high WSS values accompanied by positive WSSG. Conclusions The development of IAs is determined by an independent effect of haemodynamic factors. High WSS impacts MCA aneurysm formation, while a positive WSSG mainly promotes this process. |
| تدمد: | 1471-2377 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f977d0c4f3beda3fe5a2b96afc05d829Test https://pubmed.ncbi.nlm.nih.gov/34281533Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f977d0c4f3beda3fe5a2b96afc05d829 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712377 |
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