Differences in hemodynamics and rupture rate of aneurysms at the bifurcation of the basilar and internal carotid arteries

R. Doddasomayajula, Bong Jae Chung, F. Hamzei-Sichani, C. M. Putman, J. R. Cebral

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Abstract

Background and Purpose: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates. MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate 43%) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate 20%) were analyzed with image-based computational fluid dynamics. Several hemodynamic variables were compared among aneurysms at each location and between ruptured and unruptured aneurysms at each location. RESULTS: On average, aneurysms at the basilar tip had more concentrated inflow (P <.001), a larger inflow rate (P <.001), a larger maximum oscillatory shear index (P <.003), more complex flows (P <.033), and smaller areas under low wall shear stress (P <.001) than aneurysms at the bifurcation of the internal carotid artery. In general, ruptured aneurysms had larger inflow concentration (P <.02), larger shear concentration (P <.02), more complex flows (P <.001), and smaller minimum wall shear stress (P <.003) than unruptured aneurysms. CONCLUSIONS: High flow conditions, characterized by large and concentrated inflow jets, complex and oscillatory flow patterns, and wall shear stress distributions with focalized regions of high shear and large regions of low shear, are associated with aneurysm rupture, especially for basilar tip aneurysms. The higher flow conditions in basilar tip aneurysms could explain their increased rupture risk compared with internal carotid bifurcation aneurysms.

Original languageEnglish
Pages (from-to)570-576
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume38
Issue number3
DOIs
StatePublished - 1 Mar 2017

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Internal Carotid Artery
Aneurysm
Rupture
Hemodynamics
Ruptured Aneurysm
Basilar Artery
Intracranial Aneurysm
Hydrodynamics

Cite this

Doddasomayajula, R. ; Chung, Bong Jae ; Hamzei-Sichani, F. ; Putman, C. M. ; Cebral, J. R. / Differences in hemodynamics and rupture rate of aneurysms at the bifurcation of the basilar and internal carotid arteries. In: American Journal of Neuroradiology. 2017 ; Vol. 38, No. 3. pp. 570-576.
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title = "Differences in hemodynamics and rupture rate of aneurysms at the bifurcation of the basilar and internal carotid arteries",
abstract = "Background and Purpose: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates. MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate 43{\%}) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate 20{\%}) were analyzed with image-based computational fluid dynamics. Several hemodynamic variables were compared among aneurysms at each location and between ruptured and unruptured aneurysms at each location. RESULTS: On average, aneurysms at the basilar tip had more concentrated inflow (P <.001), a larger inflow rate (P <.001), a larger maximum oscillatory shear index (P <.003), more complex flows (P <.033), and smaller areas under low wall shear stress (P <.001) than aneurysms at the bifurcation of the internal carotid artery. In general, ruptured aneurysms had larger inflow concentration (P <.02), larger shear concentration (P <.02), more complex flows (P <.001), and smaller minimum wall shear stress (P <.003) than unruptured aneurysms. CONCLUSIONS: High flow conditions, characterized by large and concentrated inflow jets, complex and oscillatory flow patterns, and wall shear stress distributions with focalized regions of high shear and large regions of low shear, are associated with aneurysm rupture, especially for basilar tip aneurysms. The higher flow conditions in basilar tip aneurysms could explain their increased rupture risk compared with internal carotid bifurcation aneurysms.",
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Differences in hemodynamics and rupture rate of aneurysms at the bifurcation of the basilar and internal carotid arteries. / Doddasomayajula, R.; Chung, Bong Jae; Hamzei-Sichani, F.; Putman, C. M.; Cebral, J. R.

In: American Journal of Neuroradiology, Vol. 38, No. 3, 01.03.2017, p. 570-576.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Differences in hemodynamics and rupture rate of aneurysms at the bifurcation of the basilar and internal carotid arteries

AU - Doddasomayajula, R.

AU - Chung, Bong Jae

AU - Hamzei-Sichani, F.

AU - Putman, C. M.

AU - Cebral, J. R.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background and Purpose: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates. MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate 43%) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate 20%) were analyzed with image-based computational fluid dynamics. Several hemodynamic variables were compared among aneurysms at each location and between ruptured and unruptured aneurysms at each location. RESULTS: On average, aneurysms at the basilar tip had more concentrated inflow (P <.001), a larger inflow rate (P <.001), a larger maximum oscillatory shear index (P <.003), more complex flows (P <.033), and smaller areas under low wall shear stress (P <.001) than aneurysms at the bifurcation of the internal carotid artery. In general, ruptured aneurysms had larger inflow concentration (P <.02), larger shear concentration (P <.02), more complex flows (P <.001), and smaller minimum wall shear stress (P <.003) than unruptured aneurysms. CONCLUSIONS: High flow conditions, characterized by large and concentrated inflow jets, complex and oscillatory flow patterns, and wall shear stress distributions with focalized regions of high shear and large regions of low shear, are associated with aneurysm rupture, especially for basilar tip aneurysms. The higher flow conditions in basilar tip aneurysms could explain their increased rupture risk compared with internal carotid bifurcation aneurysms.

AB - Background and Purpose: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates. MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate 43%) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate 20%) were analyzed with image-based computational fluid dynamics. Several hemodynamic variables were compared among aneurysms at each location and between ruptured and unruptured aneurysms at each location. RESULTS: On average, aneurysms at the basilar tip had more concentrated inflow (P <.001), a larger inflow rate (P <.001), a larger maximum oscillatory shear index (P <.003), more complex flows (P <.033), and smaller areas under low wall shear stress (P <.001) than aneurysms at the bifurcation of the internal carotid artery. In general, ruptured aneurysms had larger inflow concentration (P <.02), larger shear concentration (P <.02), more complex flows (P <.001), and smaller minimum wall shear stress (P <.003) than unruptured aneurysms. CONCLUSIONS: High flow conditions, characterized by large and concentrated inflow jets, complex and oscillatory flow patterns, and wall shear stress distributions with focalized regions of high shear and large regions of low shear, are associated with aneurysm rupture, especially for basilar tip aneurysms. The higher flow conditions in basilar tip aneurysms could explain their increased rupture risk compared with internal carotid bifurcation aneurysms.

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U2 - 10.3174/ajnr.A5088

DO - 10.3174/ajnr.A5088

M3 - Article

VL - 38

SP - 570

EP - 576

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 3

ER -