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01-10-2018 | Original Article - Vascular Neurosurgery - Aneurysm

Vascular responses to abrupt blood flow change after bypass surgery for complex intracranial aneurysms

Authors: Hiroharu Kataoka, Yasuhide Makino, Kiyofumi Takanishi, Yohei Kimura, Kenji Takamura, Takanobu Yagi, Satoshi Iguchi, Akihide Yamamoto, Hidehiro Iida, Soshiro Ogata, Kunihiro Nishimura, Masanori Nakamura, Mitsuo Umezu, Koji Iihara, Jun C Takahashi

Published in: Acta Neurochirurgica | Issue 10/2018

Abstract

Background

Bypass surgery for complex intracranial aneurysms (IAs) results in drastic blood flow changes in intracranial arteries. The aim of the study was to elucidate how vessels adapt to blood flow changes after bypass surgery with phase-contrast magnetic resonance imaging (PC-MRI).

Methods

This is a prospective observational study to assess changes of the blood flow in intracranial arteries after bypass surgery for IAs. Flow rates and vessel diameters were measured with PC-MRI in 52 intracranial arteries of 7 healthy volunteers and 31 arteries of 8 IA patients who underwent bypass surgery. Wall shear stress (WSS) was calculated with the Hagen-Poiseuille formula. In 18 arteries of 5 patients, the same measurement was performed 1, 3, and 12 months after surgery.

Results

PC-MRI showed a strong positive correlation between the flow rate and the third power of vessel diameter in both healthy volunteers (r = 0.82, P < 0.0001) and IA patients (r = 0.90, P < 0.0001), indicating the constant WSS. Of the 18 arteries in 5 patients, WSS increased in 7 arteries and decreased in 11 arteries immediately after surgery. In the WSS-increased group, WSS returned to the preoperative value in the third postoperative month. In the WSS-decreased group, WSS increased in the 12th month, but did not return to the preoperative level.

Conclusions

In a physiological state, WSS was constant in intracranial arteries. Changed WSS after bypass surgery tended to return to the preoperative value, suggesting that vessel diameter and flow rate might be controlled so that WSS remains constant.

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Title: Vascular responses to abrupt blood flow change after bypass surgery for complex intracranial aneurysms
Authors: Hiroharu Kataoka
Yasuhide Makino
Kiyofumi Takanishi
Yohei Kimura
Kenji Takamura
Takanobu Yagi
Satoshi Iguchi
Akihide Yamamoto
Hidehiro Iida
Soshiro Ogata
Kunihiro Nishimura
Masanori Nakamura
Mitsuo Umezu
Koji Iihara
Jun C Takahashi
Publication date: 01-10-2018
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 10/2018
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-018-3653-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Vascular responses to abrupt blood flow change after bypass surgery for complex intracranial aneurysms

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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