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Differences and Correlations of Morphological and Hemodynamic Parameters between Anterior Circulation Bifurcation and Side-wall Aneurysms

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Abstract

Objective

The objective of this research was to explore the difference and correlation of the morphological and hemodynamic features between sidewall and bifurcation aneurysms in anterior circulation arteries, utilizing computational fluid dynamics as a tool for analysis.

Methods

In line with the designated inclusion criteria, this study covered 160 aneurysms identified in 131 patients who received treatment at Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, China, from January 2021 to September 2022. Utilizing follow-up digital subtraction angiography (DSA) data, these cases were classified into two distinct groups: the sidewall aneurysm group and the bifurcation aneurysm group. Morphological and hemodynamic parameters in the immediate preoperative period were meticulously calculated and examined in both groups using a three-dimensional DSA reconstruction model.

Results

No significant differences were found in the morphological or hemodynamic parameters of bifurcation aneurysms at varied locations within the anterior circulation. However, pronounced differences were identified between sidewall and bifurcation aneurysms in terms of morphological parameters such as the diameter of the parent vessel (Dvessel), inflow angle (θF), and size ratio (SR), as well as the hemodynamic parameter of inflow concentration index (ICI) (P<0.001). Notably, only the SR exhibited a significant correlation with multiple hemodynamic parameters (P<0.001), while the ICI was closely related to several morphological parameters (R>0.5, P<0.001).

Conclusions

The significant differences in certain morphological and hemodynamic parameters between sidewall and bifurcation aneurysms emphasize the importance to contemplate variances in threshold values for these parameters when evaluating the risk of rupture in anterior circulation aneurysms. Whether it is a bifurcation or sidewall aneurysm, these disparities should be considered. The morphological parameter SR has the potential to be a valuable clinical tool for promptly distinguishing the distinct rupture risks associated with sidewall and bifurcation aneurysms.

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Author notes

  1. These authors contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Kai-kai Guo, Yi-ke Cai & Xue-bin Hu

  2. Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China

    Chang-ya Liu

  3. Artery Flow Technology Co., Ltd., Hangzhou, 310051, China

    Gao-hui Li, Jian-ping Xiang & Xiao-chang Leng

Authors
  1. Kai-kai Guo
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  2. Chang-ya Liu
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  3. Gao-hui Li
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  4. Jian-ping Xiang
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  5. Xiao-chang Leng
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  6. Yi-ke Cai
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  7. Xue-bin Hu
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Correspondence to Xue-bin Hu.

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Guo, Kk., Liu, Cy., Li, Gh. et al. Differences and Correlations of Morphological and Hemodynamic Parameters between Anterior Circulation Bifurcation and Side-wall Aneurysms. CURR MED SCI 44, 391–398 (2024). https://doi.org/10.1007/s11596-024-2846-6

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  • DOI: https://doi.org/10.1007/s11596-024-2846-6

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