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Low Wall Shear Stress and High Intra-aneurysmal Pressure are Associated with Ruptured Status of Vertebral Artery Dissecting Aneurysms

  • Clinical Investigation
  • Stroke/Neurointerventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The morphological and hemodynamic features of patients with vertebral artery dissecting aneurysms (VADAs) are yet unknown. This study sought to elucidate morphological and hemodynamic features of patients with ruptured and unruptured VADAs based on computed flow simulation.

Methods

Fifty-two patients (31 unruptured and 21 ruptured VADAs) were admitted to two hospitals between March 2016 and October 2021. All VADAs were located in the intradural segment, and their clinical, morphological, and hemodynamic parameters were retrospectively analyzed. The hemodynamic parameters were determined through computational fluid dynamics simulations. Univariate statistical and multivariable logistic regression analyses were employed to select significantly different parameters and identify key factors. Receiver operating characteristic (ROC) analysis was used to assess the discrimination for each key factor.

Results

Four hemodynamic parameters were observed to significantly differ between ruptured and unruptured VADAs, including wall shear stress (WSS), low shear area, intra-aneurysmal pressure (IAP), and relative residence time. However, no significant differences were observed in morphological parameters between ruptured and unruptured VADAs. Multivariable logistic regression analysis revealed that low WSS and high IAP were significantly observed in the ruptured VADAs and demonstrated adequate discrimination.

Conclusions

This research indicates significant hemodynamic differences, but no morphological differences were observed between ruptured and unruptured VADAs. The ruptured group had significantly lower WSS and higher IAP than the unruptured group. To further confirm the roles of low WSS and high IAP in the rupture of VADAs, large prospective studies and long-term follow-up of unruptured VADAs are required.

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Funding

This study was funded by National Natural Science Foundation of China (Grant Nos: 81971870 and 82172173).

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Author notes

  1. Heng Wei and Kun Yao have contributed equally to this study.

Authors and Affiliations

  1. Department of Neurosurgery, Renmin Hospital of Wuhan University, 99 Ziyang Road, Wuhan, 430060, Hubei Province, China

    Heng Wei, Qi Tian, Shoumeng Han, Wenrui Han, Sheng Liu, Guijun Wang, Qianxue Chen & Mingchang Li

  2. Department of Neurosurgery, Jingzhou Central Hospital, Jingzhou, 434020, China

    Kun Yao & Wenhong Gao

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  1. Heng Wei
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  2. Kun Yao
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  3. Qi Tian
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Contributions

HW, KY, WG, QC and ML contributed to the conception, design and drafted the manuscript. HW, QT, SH, WH, SL, GW contributed to data acquisition and data analysis, HW, KY, QC and ML made the article preparation, editing and review. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Mingchang Li.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The retrospective study was approved by the Clinical Research Ethics Committee of Renmin Hospital of Wuhan University and Jingzhou Central Hospital.

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Informed consent was obtained from all individual participants included in the study.

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Consent for publication was obtained for every individual person’s data included in the study.

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Wei, H., Yao, K., Tian, Q. et al. Low Wall Shear Stress and High Intra-aneurysmal Pressure are Associated with Ruptured Status of Vertebral Artery Dissecting Aneurysms. Cardiovasc Intervent Radiol 46, 240–248 (2023). https://doi.org/10.1007/s00270-022-03353-2

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