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Acta Neurochirurgica

, Volume 160, Issue 10, pp 1945–1953 | Cite as

Vascular responses to abrupt blood flow change after bypass surgery for complex intracranial aneurysms

  • Hiroharu Kataoka
  • Yasuhide Makino
  • Kiyofumi Takanishi
  • Yohei Kimura
  • Kenji Takamura
  • Takanobu Yagi
  • Satoshi Iguchi
  • Akihide Yamamoto
  • Hidehiro Iida
  • Soshiro Ogata
  • Kunihiro Nishimura
  • Masanori Nakamura
  • Mitsuo Umezu
  • Koji Iihara
  • Jun C Takahashi
Original Article - Vascular Neurosurgery - Aneurysm
Part of the following topical collections:
  1. Vascular Neurosurgery – Aneurysm

Abstract

Background

Bypass surgery for complex intracranial aneurysms (IAs) results in drastic blood flow changes in intracranial arteries. The aim of the study was to elucidate how vessels adapt to blood flow changes after bypass surgery with phase-contrast magnetic resonance imaging (PC-MRI).

Methods

This is a prospective observational study to assess changes of the blood flow in intracranial arteries after bypass surgery for IAs. Flow rates and vessel diameters were measured with PC-MRI in 52 intracranial arteries of 7 healthy volunteers and 31 arteries of 8 IA patients who underwent bypass surgery. Wall shear stress (WSS) was calculated with the Hagen-Poiseuille formula. In 18 arteries of 5 patients, the same measurement was performed 1, 3, and 12 months after surgery.

Results

PC-MRI showed a strong positive correlation between the flow rate and the third power of vessel diameter in both healthy volunteers (r = 0.82, P < 0.0001) and IA patients (r = 0.90, P < 0.0001), indicating the constant WSS. Of the 18 arteries in 5 patients, WSS increased in 7 arteries and decreased in 11 arteries immediately after surgery. In the WSS-increased group, WSS returned to the preoperative value in the third postoperative month. In the WSS-decreased group, WSS increased in the 12th month, but did not return to the preoperative level.

Conclusions

In a physiological state, WSS was constant in intracranial arteries. Changed WSS after bypass surgery tended to return to the preoperative value, suggesting that vessel diameter and flow rate might be controlled so that WSS remains constant.

Keywords

Intracranial aneurysm Bypass surgery Phase contrast Magnetic resonance imaging Wall shear stress 

Abbreviations

IA

Intracranial aneurysm

PC-MRI

Phase-contrast magnetic resonance imaging

WSS

Wall shear stress

EC-IC bypass

Extracranial-intracranial bypass

RA

Radial artery

SV

Saphenous vein

ICA

Internal carotid artery

MCA

Middle cerebral artery

STA

Superficial temporal artery

SCA

Superior cerebellar artery

NEX

Number of excitations

VENC

Velocity encoding

FOV

Field of view

ANOVA

Analysis of variance

EC

Endothelial cell

SMC

Smooth muscle cell

Notes

Acknowledgements

The authors would like to thank Yoshifumi Hayashi M.D. and Hirotaka Yoshida M.D. at Kitahara International Hospital, Tokyo, Japan, for PC-MRI measurements of healthy volunteers.

Funding

This work was supported in part by Grants-in-aid for Scientific Research (grant numbers: 24592150 and 15H04952) from the Japan Society for the Promotion of Science and The Ministry of Education, Culture, Sports, Science, and Technology of Japan.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. This study was approved by the Institutional Review Board at our institutes.

Informed consent

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

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Hiroharu Kataoka
    • 1
    • 2
  • Yasuhide Makino
    • 1
    • 2
  • Kiyofumi Takanishi
    • 3
  • Yohei Kimura
    • 3
  • Kenji Takamura
    • 3
  • Takanobu Yagi
    • 3
  • Satoshi Iguchi
    • 4
  • Akihide Yamamoto
    • 4
  • Hidehiro Iida
    • 4
  • Soshiro Ogata
    • 5
  • Kunihiro Nishimura
    • 5
  • Masanori Nakamura
    • 6
  • Mitsuo Umezu
    • 3
  • Koji Iihara
    • 7
  • Jun C Takahashi
    • 1
  1. 1.Department of NeurosurgeryNational Cerebral and Cardiovascular CenterKyotoJapan
  2. 2.Department of Neurosurgery, Graduate School of MedicineKyoto UniversityKyotoJapan
  3. 3.Center for Advanced Biomedical Science (TWIns)Waseda UniversityTokyoJapan
  4. 4.Department of Investigative RadiologyNational Cerebral and Cardiovascular Center Research InstituteOsakaJapan
  5. 5.Center for Cerebral and Cardiovascular Disease InformationNational Cerebral and Cardiovascular CenterSuitaJapan
  6. 6.Department of Mechanical EngineeringNagoya Institute of TechnologyNagoyaJapan
  7. 7.Department of Neurosurgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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