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Are hemodynamics of irregular small carotid-ophthalmic aneurysms different from those of regular ones and large aneurysms based on numerical simulation?

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Abstract

Purpose

The purpose of this study is to investigate whether hemodynamics of unruptured, irregular small intracranial aneurysms (SIAs) are different from those of regular ones and large intracranial aneurysms (LIAs) in ophthalmic artery segment of internal carotid artery (ICA).

Methods

Between April 2015 and June 2018, 106 carotid-ophthalmic artery aneurysms were retrospectively analyzed using 3D angiographic images and computational fluid dynamics (CFD). Three categories were stratified: regular SIAs, irregular SIAs and LIAs. Statistical comparisons of the differences in clinical, morphological and hemodynamic parameters among regular SIA, irregular SIA and LIA groups were performed by one-way analysis of variance (ANOVA) or Kruskal–Wallis Test.

Results

The median maximal height of regular SIA, irregular SIA and LIA were 3.03 (interquartile range: 2.49–4.22) mm, 4.59 (interquartile range: 3.86–5.32) mm and 11.06 (interquartile range: 9.28–13.69) mm, all P < 0.05). Low shear-stress area percentage (LSA%) and oscillatory shear index (OSI) of irregular SIAs and LIAs were not significantly different (P = 0.72, P = 0.27 respectively), and were significantly higher than those of regular SIAs (all P < 0.01). Wall shear stress (WSS) and normalized wall shear stress (NWSS) of irregular SIAs were significantly higher than those of LIAs (P < 0.01, P < 0.01 respectively), but lower than those of regular SIAs (P < 0.01, P < 0.01 respectively).

Conclusions

Special unruptured irregular SIAs share a similarity of hemodynamic characteristics with LIAs in high LSA% and high OSI, and are different from regular SIAs in hemodynamics.

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Correspondence to Xiaolong Zhang.

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We declare that we have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Wan, H., Huang, L., Ge, L. et al. Are hemodynamics of irregular small carotid-ophthalmic aneurysms different from those of regular ones and large aneurysms based on numerical simulation?. Neuroradiology (2020) doi:10.1007/s00234-019-02348-0

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Keywords

  • Hemodynamics
  • Morphology
  • Small intracranial aneurysms
  • Wall shear stress
  • Rupture