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Surface area may be a more useful risk factor for cerebral aneurysm rupture than maximum diameter
Author(s) -
Fukuda Shunichi,
Shimogona Yuji
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.659.17
Subject(s) - aneurysm , medicine , hemodynamics , shear stress , body surface area , cardiology , radiology , materials science , composite material
The maximum diameter of unruptured cerebral aneurysms is the most significant risk factor of aneurysm rupture. The larger the aneurysm, the easier it is to rupture, and a size of 7 mm or more is clinically significant. This is thought to be at least partially due to hemodynamic involvement. We show here associations between hemodynamic factors and maximum diameter and surface area of cerebral aneurysms by regression analysis. Methods We are conducting a multi‐institutional prospective observational clinical study to examine hemodynamics of human aneurysm development, enlargement, and rupture using computational fluid dynamics (CFD); CFD ABO Study. Three‐dimensional CT angiographic images and flow velocities were acquired from 74 patients in the Study. Results WSS, NWSS, and WSSG, which are metrics for wall shear stress, at the maximum diameter of 7 mm or more and the surface area of 40 mm 2 or more are significantly lower than these at the maximum diameter less than 7 mm and the surface area less than 40 mm 2 , respectively. Similarly, OSI, GON, and NtransWSS, which are metrics for disturbed flow, at the formers are significantly higher than those at the latters. In addition, the associations between surface area and NWSS, WSSG, GON, or NtransWSS are significant (regression coefficient, 1.548, 1.933, −0.0188, −0.0184, respectively, 95%CI, 0.047 – 3.048, 0.205 – 3.662, −0.033 – −0.0045, −0.035 – −0.021, respectively, P<0.05), but the associations between them and maximum diameter are not at all (Table). Conclusions Lower shear stress and stronger disturbed flow are reported to be risk factors for aneurysm rupture. The data by these regression analyses suggest that the surface area is a more useful risk factor for cerebral aneurysm rupture than the maximum diameter. Support or Funding Information This study is supported by the Grant‐in‐Aid for the Japanese National Hospital Organization Multi‐Center Clinical Research and AME‐CREST, AMED.