Angioarchitectures and hemodynamic characteristics of posterior communicating artery aneurysms and their association with rupture status

Bong Jae Chung, R. Doddasomayajula, F. Mut, F. Detmer, M. B. Pritz, F. Hamzei-Sichani, W. Brinjikji, D. F. Kallmes, C. M. Jimenez, C. M. Putman, J. R. Cebral

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Abstract

BACKGROUND AND PURPOSE: Intracranial aneurysms originating at the posterior communicating artery are known to have high rupture risk compared with other locations. We tested the hypothesis that different angioarchitectures (ie, branch point configuration) of posterior communicating artery aneurysms are associated with aneurysm hemodynamics, which in turn predisposes aneurysms to rupture. MATERIALS AND METHODS: A total of 313 posterior communicating artery aneurysms (145 ruptured, 168 unruptured) were studied with image-based computational fluid dynamics. Aneurysms were classified into different angioarchitecture types depending on the location of the aneurysm with respect to parent artery bifurcation. Hemodynamic characteristics were compared between ruptured and unruptured aneurysms, as well as among aneurysms with different angioarchitectures. RESULTS: Angioarchitecture was associated with rupture (P =; .003). Ruptured aneurysms had higher, more concentrated, and more oscillatory wall shear stress distributions (maximum wall shear stress, P<.001; shear concentration index, P<.001; mean oscillatory shear index, P < .001), stronger and more concentrated inflow jets (represented as Q, P < .01; inflow concentration index, P < .001), and more complex and unstable flow patterns (vortex core length, P < .001; proper orthogonal decomposition entropy, P < .001) compared with unruptured aneurysms. These adverse conditions were more common in aneurysms with bifurcation-type angioarchitectures compared with those with lateral or sidewall angioarchitectures. Interestingly, ruptured aneurysms also had lower normalized mean wall shear stress (P < .02) and minimum wall shear stress (P < .002) than unruptured aneurysms. CONCLUSIONS: High-flow intrasaccular hemodynamic characteristics, commonly found in bifurcation-type angioarchitectures, are associated with the posterior communicating artery aneurysm rupture status. These characteristics include strong and concentrated inflow jets, concentrated regions of elevated wall shear stress, oscillatory wall shear stress, lower normalized wall shear stress, and complex and unstable flow patterns.

Original languageEnglish
Pages (from-to)2111-2118
Number of pages8
JournalAmerican Journal of Neuroradiology
Volume38
Issue number11
DOIs
StatePublished - 1 Nov 2017

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Intracranial Aneurysm
Aneurysm
Rupture
Hemodynamics
Ruptured Aneurysm
Arteries
Entropy
Hydrodynamics

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Chung, Bong Jae ; Doddasomayajula, R. ; Mut, F. ; Detmer, F. ; Pritz, M. B. ; Hamzei-Sichani, F. ; Brinjikji, W. ; Kallmes, D. F. ; Jimenez, C. M. ; Putman, C. M. ; Cebral, J. R. / Angioarchitectures and hemodynamic characteristics of posterior communicating artery aneurysms and their association with rupture status. In: American Journal of Neuroradiology. 2017 ; Vol. 38, No. 11. pp. 2111-2118.
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title = "Angioarchitectures and hemodynamic characteristics of posterior communicating artery aneurysms and their association with rupture status",
abstract = "BACKGROUND AND PURPOSE: Intracranial aneurysms originating at the posterior communicating artery are known to have high rupture risk compared with other locations. We tested the hypothesis that different angioarchitectures (ie, branch point configuration) of posterior communicating artery aneurysms are associated with aneurysm hemodynamics, which in turn predisposes aneurysms to rupture. MATERIALS AND METHODS: A total of 313 posterior communicating artery aneurysms (145 ruptured, 168 unruptured) were studied with image-based computational fluid dynamics. Aneurysms were classified into different angioarchitecture types depending on the location of the aneurysm with respect to parent artery bifurcation. Hemodynamic characteristics were compared between ruptured and unruptured aneurysms, as well as among aneurysms with different angioarchitectures. RESULTS: Angioarchitecture was associated with rupture (P =; .003). Ruptured aneurysms had higher, more concentrated, and more oscillatory wall shear stress distributions (maximum wall shear stress, P<.001; shear concentration index, P<.001; mean oscillatory shear index, P < .001), stronger and more concentrated inflow jets (represented as Q, P < .01; inflow concentration index, P < .001), and more complex and unstable flow patterns (vortex core length, P < .001; proper orthogonal decomposition entropy, P < .001) compared with unruptured aneurysms. These adverse conditions were more common in aneurysms with bifurcation-type angioarchitectures compared with those with lateral or sidewall angioarchitectures. Interestingly, ruptured aneurysms also had lower normalized mean wall shear stress (P < .02) and minimum wall shear stress (P < .002) than unruptured aneurysms. CONCLUSIONS: High-flow intrasaccular hemodynamic characteristics, commonly found in bifurcation-type angioarchitectures, are associated with the posterior communicating artery aneurysm rupture status. These characteristics include strong and concentrated inflow jets, concentrated regions of elevated wall shear stress, oscillatory wall shear stress, lower normalized wall shear stress, and complex and unstable flow patterns.",
author = "Chung, {Bong Jae} and R. Doddasomayajula and F. Mut and F. Detmer and Pritz, {M. B.} and F. Hamzei-Sichani and W. Brinjikji and Kallmes, {D. F.} and Jimenez, {C. M.} and Putman, {C. M.} and Cebral, {J. R.}",
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Chung, BJ, Doddasomayajula, R, Mut, F, Detmer, F, Pritz, MB, Hamzei-Sichani, F, Brinjikji, W, Kallmes, DF, Jimenez, CM, Putman, CM & Cebral, JR 2017, 'Angioarchitectures and hemodynamic characteristics of posterior communicating artery aneurysms and their association with rupture status', American Journal of Neuroradiology, vol. 38, no. 11, pp. 2111-2118. https://doi.org/10.3174/ajnr.A5358

Angioarchitectures and hemodynamic characteristics of posterior communicating artery aneurysms and their association with rupture status. / Chung, Bong Jae; Doddasomayajula, R.; Mut, F.; Detmer, F.; Pritz, M. B.; Hamzei-Sichani, F.; Brinjikji, W.; Kallmes, D. F.; Jimenez, C. M.; Putman, C. M.; Cebral, J. R.

In: American Journal of Neuroradiology, Vol. 38, No. 11, 01.11.2017, p. 2111-2118.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Angioarchitectures and hemodynamic characteristics of posterior communicating artery aneurysms and their association with rupture status

AU - Chung, Bong Jae

AU - Doddasomayajula, R.

AU - Mut, F.

AU - Detmer, F.

AU - Pritz, M. B.

AU - Hamzei-Sichani, F.

AU - Brinjikji, W.

AU - Kallmes, D. F.

AU - Jimenez, C. M.

AU - Putman, C. M.

AU - Cebral, J. R.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - BACKGROUND AND PURPOSE: Intracranial aneurysms originating at the posterior communicating artery are known to have high rupture risk compared with other locations. We tested the hypothesis that different angioarchitectures (ie, branch point configuration) of posterior communicating artery aneurysms are associated with aneurysm hemodynamics, which in turn predisposes aneurysms to rupture. MATERIALS AND METHODS: A total of 313 posterior communicating artery aneurysms (145 ruptured, 168 unruptured) were studied with image-based computational fluid dynamics. Aneurysms were classified into different angioarchitecture types depending on the location of the aneurysm with respect to parent artery bifurcation. Hemodynamic characteristics were compared between ruptured and unruptured aneurysms, as well as among aneurysms with different angioarchitectures. RESULTS: Angioarchitecture was associated with rupture (P =; .003). Ruptured aneurysms had higher, more concentrated, and more oscillatory wall shear stress distributions (maximum wall shear stress, P<.001; shear concentration index, P<.001; mean oscillatory shear index, P < .001), stronger and more concentrated inflow jets (represented as Q, P < .01; inflow concentration index, P < .001), and more complex and unstable flow patterns (vortex core length, P < .001; proper orthogonal decomposition entropy, P < .001) compared with unruptured aneurysms. These adverse conditions were more common in aneurysms with bifurcation-type angioarchitectures compared with those with lateral or sidewall angioarchitectures. Interestingly, ruptured aneurysms also had lower normalized mean wall shear stress (P < .02) and minimum wall shear stress (P < .002) than unruptured aneurysms. CONCLUSIONS: High-flow intrasaccular hemodynamic characteristics, commonly found in bifurcation-type angioarchitectures, are associated with the posterior communicating artery aneurysm rupture status. These characteristics include strong and concentrated inflow jets, concentrated regions of elevated wall shear stress, oscillatory wall shear stress, lower normalized wall shear stress, and complex and unstable flow patterns.

AB - BACKGROUND AND PURPOSE: Intracranial aneurysms originating at the posterior communicating artery are known to have high rupture risk compared with other locations. We tested the hypothesis that different angioarchitectures (ie, branch point configuration) of posterior communicating artery aneurysms are associated with aneurysm hemodynamics, which in turn predisposes aneurysms to rupture. MATERIALS AND METHODS: A total of 313 posterior communicating artery aneurysms (145 ruptured, 168 unruptured) were studied with image-based computational fluid dynamics. Aneurysms were classified into different angioarchitecture types depending on the location of the aneurysm with respect to parent artery bifurcation. Hemodynamic characteristics were compared between ruptured and unruptured aneurysms, as well as among aneurysms with different angioarchitectures. RESULTS: Angioarchitecture was associated with rupture (P =; .003). Ruptured aneurysms had higher, more concentrated, and more oscillatory wall shear stress distributions (maximum wall shear stress, P<.001; shear concentration index, P<.001; mean oscillatory shear index, P < .001), stronger and more concentrated inflow jets (represented as Q, P < .01; inflow concentration index, P < .001), and more complex and unstable flow patterns (vortex core length, P < .001; proper orthogonal decomposition entropy, P < .001) compared with unruptured aneurysms. These adverse conditions were more common in aneurysms with bifurcation-type angioarchitectures compared with those with lateral or sidewall angioarchitectures. Interestingly, ruptured aneurysms also had lower normalized mean wall shear stress (P < .02) and minimum wall shear stress (P < .002) than unruptured aneurysms. CONCLUSIONS: High-flow intrasaccular hemodynamic characteristics, commonly found in bifurcation-type angioarchitectures, are associated with the posterior communicating artery aneurysm rupture status. These characteristics include strong and concentrated inflow jets, concentrated regions of elevated wall shear stress, oscillatory wall shear stress, lower normalized wall shear stress, and complex and unstable flow patterns.

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DO - 10.3174/ajnr.A5358

M3 - Article

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JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 11

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