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Discrimination of intracranial aneurysm rupture status: patient-specific inflow boundary may not be a must-have condition in hemodynamic simulations

  • Interventional Neuroradiology
  • Published:
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Abstract

Background

Computational fluid dynamics (CFD) are important in evaluating the hemodynamics of intracranial aneurysm rupture, and the setting of inflow boundary conditions is critical. We evaluated intracranial aneurysm hemodynamics based on generalized versus patient-specific inflow boundary conditions to examine the effect of different hemodynamic results on the discrimination of intracranial aneurysm rupture status.

Methods

We enrolled 148 patients with 156 intracranial aneurysms. For each included aneurysm, we performed CFD simulation once based on patient-specific and once based on generalized inflow boundary conditions. First, we compared the hemodynamics of intracranial aneurysms based on different inflow boundary conditions. Then, we divided the included aneurysms into a ruptured and unruptured group and compared the hemodynamics between the two groups under patient-specific and generalized inflow boundary conditions.

Results

For the hemodynamic parameters using specific inflow boundary conditions, more complex flow (p = 0.002), larger minimum WSS (p = 0.024), lower maximum low WSS area (LSA) (p = 0.038), and oscillatory shear index (p = 0.002) were found. Furthermore, we compared the hemodynamics between ruptured and unruptured groups based on different inflow boundary conditions. We found that the significant hemodynamic parameters associated with rupture status were the same, including the proportion of aneurysms with flow complex and unstable flow and the minimum and maximum of LSA (p = 0.011, p = 0.003, p = 0.001 and p = 0.004, respectively).

Conclusion

Patient-specific and generalized inflow boundary conditions of aneurysmal hemodynamics resulted in significant differences. However, the significant parameters associated with rupture status were the same in both conditions, indicating that patient-specific inflow boundary conditions may not be necessary for predicting rupture risk.

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Abbreviations

WSS:

Wall shear stress

CFD:

Computational fluid dynamics

TCD:

Transcranial Doppler sonography

TAWSS:

Time-averaged WSS

OSI:

Oscillatory shear index

LSA:

Low WSS area

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Funding

This work was supported by National Key Research and Development Plan of China (grant number: 2016YFC1300800), the National Natural Science Foundation of China (grant numbers: 81801156, 81801158, 81471167, and 81671139), the Special Research Project for Capital Health Development (grant number: 2018-4-1077), Beijing Hospitals Authority Youth Programme (code: QML20190503), the Innovation Fund of Nanchang University for Graduate Students (No. cx2016312).

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Authors and Affiliations

  1. Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, NansanhuanXilu 119, Fengtai District, Beijing, 100070, China

    Wenqiang Li, Zhongbin Tian, Wei Zhu, Yisen Zhang, Ying Zhang, Kun Wang, Xinjian Yang & Jian Liu

  2. Institute of Biomechanics, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China

    Shengzhang Wang

  3. Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China

    Yang Wang

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  1. Wenqiang Li
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  2. Shengzhang Wang
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  3. Zhongbin Tian
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  4. Wei Zhu
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  5. Yisen Zhang
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  10. Jian Liu
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Correspondence to Jian Liu.

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This study was approved by the ethics committee of Beijing Tiantan Hospital. All procedures performed in the 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.

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Li, W., Wang, S., Tian, Z. et al. Discrimination of intracranial aneurysm rupture status: patient-specific inflow boundary may not be a must-have condition in hemodynamic simulations. Neuroradiology 62, 1485–1495 (2020). https://doi.org/10.1007/s00234-020-02473-1

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