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01-03-2019 | Diagnostic Neuroradiology

Associations of hemodynamics, morphology, and patient characteristics with aneurysm rupture stratified by aneurysm location

Authors: Felicitas J. Detmer, Bong Jae Chung, Carlos Jimenez, Farid Hamzei-Sichani, David Kallmes, Christopher Putman, Juan R. Cebral

Published in: Neuroradiology | Issue 3/2019

Abstract

Purpose

The mechanisms of cerebral aneurysm rupture are not fully understood. We analyzed the associations of hemodynamics, morphology, and patient age and gender with aneurysm rupture stratifying by location.

Methods

Using image-based models, 20 hemodynamic and 17 morphological parameters were compared in 1931 ruptured and unruptured aneurysms with univariate logistic regression. Rupture rates were compared between males and females as well as younger and older patients and bifurcation versus sidewall aneurysms for different aneurysm locations. Subsequently, associations between hemodynamics and morphology and patient as well as aneurysm characteristics were analyzed for aneurysms at five locations.

Results

Compared to unruptured aneurysms, ruptured aneurysms were characterized by a more irregular shape and were exposed to a more adverse hemodynamic environment described by faster flow, higher wall shear stress, more oscillatory shear, and more unstable and complex flows. These associations with rupture status were consistent for different aneurysm locations. Rupture rates were significantly higher in males at the internal carotid artery (ICA) bifurcation, ophthalmic ICA, and the middle cerebral artery (MCA) bifurcation. At the anterior communicating artery (ACOM) and MCA bifurcation, they were significantly higher for younger patients. Bifurcation aneurysms had significantly larger rupture rates at the MCA and posterior communicating artery (PCOM). In these groups with higher rupture rates, aneurysms were characterized by adverse hemodynamics and more complex shapes.

Conclusion

Hemodynamic and morphological differences between ruptured and unruptured aneurysms are consistent across locations. Adverse morphology and hemodynamics are related to rupture as well as younger age, male gender, and bifurcation aneurysms.

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Title: Associations of hemodynamics, morphology, and patient characteristics with aneurysm rupture stratified by aneurysm location
Authors: Felicitas J. Detmer
Bong Jae Chung
Carlos Jimenez
Farid Hamzei-Sichani
David Kallmes
Christopher Putman
Juan R. Cebral
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 3/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-018-2135-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Associations of hemodynamics, morphology, and patient characteristics with aneurysm rupture stratified by aneurysm location

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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