Local hemodynamic conditions associated with focal changes in the intracranial aneurysm wall

J. R. Cebral, F. Detmer, Bong Jae Chung, J. Choque-Velasquez, B. Rezai, H. Lehto, R. Tulamo, J. Hernesniemi, M. Niemela, A. Yu, R. Williamson, K. Aziz, S. Sakur, S. Amin-Hanjani, F. Charbel, Y. Tobe, A. Robertson, J. Frösen

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Abstract

BACKGROUND AND PURPOSE: Aneurysm hemodynamics has been associated with wall histology and inflammation. We investigated associations between local hemodynamics and focal wall changes visible intraoperatively. MATERIALS AND METHODS: Computational fluid dynamics models were constructed from 3D images of 65 aneurysms treated surgically. Aneurysm regions with different visual appearances were identified in intraoperative videos: 1) “atherosclerotic” (yellow), 2) “hyperplastic” (white), 3) “thin” (red), 4) rupture site, and 5) “normal” (similar to parent artery), They were marked on 3D reconstructions. Regional hemodynamics was characterized by the following: wall shear stress, oscillatory shear index, relative residence time, wall shear stress gradient and divergence, gradient oscillatory number, and dynamic pressure; these were compared using the Mann-Whitney test. RESULTS: Hyperplastic regions had lower average wall shear stress (P .005) and pressure (P .009) than normal regions. Flow conditions in atherosclerotic and hyperplastic regions were similar but had higher average relative residence time (P .03) and oscillatory shear index (P .04) than thin regions. Hyperplastic regions also had a higher average gradient oscillatory number (P .002) than thin regions. Thin regions had lower average relative residence time (P .001), oscillatory shear index (P .006), and gradient oscillatory number (P .001) than normal regions, and higher average wall shear stress (P .006) and pressure (P .009) than hyperplastic regions. Thin regions tended to be aligned with the flow stream, while atherosclerotic and hyperplastic regions tended to be aligned with recirculation zones. CONCLUSIONS: Local hemodynamics is associated with visible focal wall changes. Slow swirling flow with low and oscillatory wall shear stress was associated with atherosclerotic and hyperplastic changes. High flow conditions prevalent in regions near the flow impingement site characterized by higher and less oscillatory wall shear stress were associated with local “thinning” of the wall.

Original languageEnglish
Pages (from-to)510-516
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume40
Issue number3
DOIs
StatePublished - 1 Jan 2019

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Intracranial Aneurysm
Hemodynamics
Aneurysm
Pressure
Hydrodynamics
Rupture
Histology
Arteries
Inflammation

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Cebral, J. R. ; Detmer, F. ; Chung, Bong Jae ; Choque-Velasquez, J. ; Rezai, B. ; Lehto, H. ; Tulamo, R. ; Hernesniemi, J. ; Niemela, M. ; Yu, A. ; Williamson, R. ; Aziz, K. ; Sakur, S. ; Amin-Hanjani, S. ; Charbel, F. ; Tobe, Y. ; Robertson, A. ; Frösen, J. / Local hemodynamic conditions associated with focal changes in the intracranial aneurysm wall. In: American Journal of Neuroradiology. 2019 ; Vol. 40, No. 3. pp. 510-516.
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title = "Local hemodynamic conditions associated with focal changes in the intracranial aneurysm wall",
abstract = "BACKGROUND AND PURPOSE: Aneurysm hemodynamics has been associated with wall histology and inflammation. We investigated associations between local hemodynamics and focal wall changes visible intraoperatively. MATERIALS AND METHODS: Computational fluid dynamics models were constructed from 3D images of 65 aneurysms treated surgically. Aneurysm regions with different visual appearances were identified in intraoperative videos: 1) “atherosclerotic” (yellow), 2) “hyperplastic” (white), 3) “thin” (red), 4) rupture site, and 5) “normal” (similar to parent artery), They were marked on 3D reconstructions. Regional hemodynamics was characterized by the following: wall shear stress, oscillatory shear index, relative residence time, wall shear stress gradient and divergence, gradient oscillatory number, and dynamic pressure; these were compared using the Mann-Whitney test. RESULTS: Hyperplastic regions had lower average wall shear stress (P .005) and pressure (P .009) than normal regions. Flow conditions in atherosclerotic and hyperplastic regions were similar but had higher average relative residence time (P .03) and oscillatory shear index (P .04) than thin regions. Hyperplastic regions also had a higher average gradient oscillatory number (P .002) than thin regions. Thin regions had lower average relative residence time (P .001), oscillatory shear index (P .006), and gradient oscillatory number (P .001) than normal regions, and higher average wall shear stress (P .006) and pressure (P .009) than hyperplastic regions. Thin regions tended to be aligned with the flow stream, while atherosclerotic and hyperplastic regions tended to be aligned with recirculation zones. CONCLUSIONS: Local hemodynamics is associated with visible focal wall changes. Slow swirling flow with low and oscillatory wall shear stress was associated with atherosclerotic and hyperplastic changes. High flow conditions prevalent in regions near the flow impingement site characterized by higher and less oscillatory wall shear stress were associated with local “thinning” of the wall.",
author = "Cebral, {J. R.} and F. Detmer and Chung, {Bong Jae} and J. Choque-Velasquez and B. Rezai and H. Lehto and R. Tulamo and J. Hernesniemi and M. Niemela and A. Yu and R. Williamson and K. Aziz and S. Sakur and S. Amin-Hanjani and F. Charbel and Y. Tobe and A. Robertson and J. Fr{\"o}sen",
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Cebral, JR, Detmer, F, Chung, BJ, Choque-Velasquez, J, Rezai, B, Lehto, H, Tulamo, R, Hernesniemi, J, Niemela, M, Yu, A, Williamson, R, Aziz, K, Sakur, S, Amin-Hanjani, S, Charbel, F, Tobe, Y, Robertson, A & Frösen, J 2019, 'Local hemodynamic conditions associated with focal changes in the intracranial aneurysm wall', American Journal of Neuroradiology, vol. 40, no. 3, pp. 510-516. https://doi.org/10.3174/ajnr.A5970

Local hemodynamic conditions associated with focal changes in the intracranial aneurysm wall. / Cebral, J. R.; Detmer, F.; Chung, Bong Jae; Choque-Velasquez, J.; Rezai, B.; Lehto, H.; Tulamo, R.; Hernesniemi, J.; Niemela, M.; Yu, A.; Williamson, R.; Aziz, K.; Sakur, S.; Amin-Hanjani, S.; Charbel, F.; Tobe, Y.; Robertson, A.; Frösen, J.

In: American Journal of Neuroradiology, Vol. 40, No. 3, 01.01.2019, p. 510-516.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Local hemodynamic conditions associated with focal changes in the intracranial aneurysm wall

AU - Cebral, J. R.

AU - Detmer, F.

AU - Chung, Bong Jae

AU - Choque-Velasquez, J.

AU - Rezai, B.

AU - Lehto, H.

AU - Tulamo, R.

AU - Hernesniemi, J.

AU - Niemela, M.

AU - Yu, A.

AU - Williamson, R.

AU - Aziz, K.

AU - Sakur, S.

AU - Amin-Hanjani, S.

AU - Charbel, F.

AU - Tobe, Y.

AU - Robertson, A.

AU - Frösen, J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BACKGROUND AND PURPOSE: Aneurysm hemodynamics has been associated with wall histology and inflammation. We investigated associations between local hemodynamics and focal wall changes visible intraoperatively. MATERIALS AND METHODS: Computational fluid dynamics models were constructed from 3D images of 65 aneurysms treated surgically. Aneurysm regions with different visual appearances were identified in intraoperative videos: 1) “atherosclerotic” (yellow), 2) “hyperplastic” (white), 3) “thin” (red), 4) rupture site, and 5) “normal” (similar to parent artery), They were marked on 3D reconstructions. Regional hemodynamics was characterized by the following: wall shear stress, oscillatory shear index, relative residence time, wall shear stress gradient and divergence, gradient oscillatory number, and dynamic pressure; these were compared using the Mann-Whitney test. RESULTS: Hyperplastic regions had lower average wall shear stress (P .005) and pressure (P .009) than normal regions. Flow conditions in atherosclerotic and hyperplastic regions were similar but had higher average relative residence time (P .03) and oscillatory shear index (P .04) than thin regions. Hyperplastic regions also had a higher average gradient oscillatory number (P .002) than thin regions. Thin regions had lower average relative residence time (P .001), oscillatory shear index (P .006), and gradient oscillatory number (P .001) than normal regions, and higher average wall shear stress (P .006) and pressure (P .009) than hyperplastic regions. Thin regions tended to be aligned with the flow stream, while atherosclerotic and hyperplastic regions tended to be aligned with recirculation zones. CONCLUSIONS: Local hemodynamics is associated with visible focal wall changes. Slow swirling flow with low and oscillatory wall shear stress was associated with atherosclerotic and hyperplastic changes. High flow conditions prevalent in regions near the flow impingement site characterized by higher and less oscillatory wall shear stress were associated with local “thinning” of the wall.

AB - BACKGROUND AND PURPOSE: Aneurysm hemodynamics has been associated with wall histology and inflammation. We investigated associations between local hemodynamics and focal wall changes visible intraoperatively. MATERIALS AND METHODS: Computational fluid dynamics models were constructed from 3D images of 65 aneurysms treated surgically. Aneurysm regions with different visual appearances were identified in intraoperative videos: 1) “atherosclerotic” (yellow), 2) “hyperplastic” (white), 3) “thin” (red), 4) rupture site, and 5) “normal” (similar to parent artery), They were marked on 3D reconstructions. Regional hemodynamics was characterized by the following: wall shear stress, oscillatory shear index, relative residence time, wall shear stress gradient and divergence, gradient oscillatory number, and dynamic pressure; these were compared using the Mann-Whitney test. RESULTS: Hyperplastic regions had lower average wall shear stress (P .005) and pressure (P .009) than normal regions. Flow conditions in atherosclerotic and hyperplastic regions were similar but had higher average relative residence time (P .03) and oscillatory shear index (P .04) than thin regions. Hyperplastic regions also had a higher average gradient oscillatory number (P .002) than thin regions. Thin regions had lower average relative residence time (P .001), oscillatory shear index (P .006), and gradient oscillatory number (P .001) than normal regions, and higher average wall shear stress (P .006) and pressure (P .009) than hyperplastic regions. Thin regions tended to be aligned with the flow stream, while atherosclerotic and hyperplastic regions tended to be aligned with recirculation zones. CONCLUSIONS: Local hemodynamics is associated with visible focal wall changes. Slow swirling flow with low and oscillatory wall shear stress was associated with atherosclerotic and hyperplastic changes. High flow conditions prevalent in regions near the flow impingement site characterized by higher and less oscillatory wall shear stress were associated with local “thinning” of the wall.

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U2 - 10.3174/ajnr.A5970

DO - 10.3174/ajnr.A5970

M3 - Article

VL - 40

SP - 510

EP - 516

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 3

ER -