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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention
Open Access

Hemodynamic Characteristics of Ruptured and Unruptured Multiple Aneurysms at Mirror and Ipsilateral Locations

R. Doddasomayajula, B.J. Chung, F. Mut, C.M. Jimenez, F. Hamzei-Sichani, C.M. Putman and J.R. Cebral
American Journal of Neuroradiology December 2017, 38 (12) 2301-2307; DOI: https://doi.org/10.3174/ajnr.A5397
R. Doddasomayajula
aFrom the Bioengineering Department (R.D., B.J.C., F.M., J.R.C.), George Mason University, Fairfax, Virginia
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B.J. Chung
aFrom the Bioengineering Department (R.D., B.J.C., F.M., J.R.C.), George Mason University, Fairfax, Virginia
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F. Mut
aFrom the Bioengineering Department (R.D., B.J.C., F.M., J.R.C.), George Mason University, Fairfax, Virginia
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C.M. Jimenez
bNeurosurgery Department (C.M.J.), University of Antioquia, Medellin, Colombia
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F. Hamzei-Sichani
cDepartment of Neurosurgery (F.H.-S.), Mt. Sinai Medical Center, New York, New York
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C.M. Putman
dInterventional Neuroradiology (C.M.P.), Inova Fairfax Hospital, Falls Church, Virginia.
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J.R. Cebral
aFrom the Bioengineering Department (R.D., B.J.C., F.M., J.R.C.), George Mason University, Fairfax, Virginia
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    Fig 1.

    Ratios of mean values of hemodynamic and geometric variables of ruptured over unruptured mirror aneurysms. Statistically significant differences (P < .05) are indicated with an asterisk, and marginally significant differences (P < .05 on 1-sided test), with a dagger. LSA indicates percentage area under low WSS; SCI, shear concentration index; Vmax, maximum flow velocity; Q, aneurysm flow rate; ICI, inflow concentration index; norm, normal; Asize, aneurysm maximum size; Nsize, neck maximum size; AR, aspect ratio (≤ depth/neck size); VO, mean aneurysm vorticity; SR, shear rates; VE, mean aneurysm velocity.

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    Fig 2.

    Ratios of mean values of hemodynamic and geometric variables of ruptured over unruptured ipsilateral aneurysms. Error bars indicate variability of the mean ratios over 100 random selections of ruptured–unruptured multiple aneurysm pairs. Statistically significant differences (Pmax < .05) are indicated with an asterisk, and marginally significant differences (mean P = .05 but Pmax > .05), with a dagger. LSA indicates percentage area under low WSS; SCI, shear concentration index; Vmax, maximum flow velocity; Q, aneurysm flow rate; ICI, inflow concentration index; norm, normal; Asize, aneurysm maximum size; Nsize, neck maximum size; AR, aspect ratio (≤depth/neck size); VO, mean aneurysm vorticity; SR, shear rates; VE, mean aneurysm velocity.

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    Fig 3.

    Example of ruptured (right posterior communicating artery aneurysm, left column) and unruptured (right posterior communicating artery aneurysm, right column) mirror aneurysm pairs. The Left panel shows from top to bottom: 3D rotational angiography images, WSS distributions, and OSI distributions. The right panel shows from top to bottom: inflow jets, flow patterns, and vortex core lines at 4 times during the cardiac cycle.

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    Fig 4.

    Example of ruptured (anterior communicating artery aneurysm fed from the left A1) and unruptured (left posterior communicating artery aneurysm) multiple ipsilateral aneurysms. The left panel shows from top to bottom: 3D rotational angiography image, WSS distributions, and OSI distributions. The right panel shows from top to bottom: inflow jets, flow patterns, and vortex core lines at 4 time instances during the cardiac cycle.

Tables

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  • Hemodynamic and geometric characteristics of ruptured and unruptured mirror and multiple ipsilateral aneurysmsa

    VariableMirror AneurysmsIpsilateral Aneurysms
    UnrupturedRupturedP ValueUnrupturedRupturedP meanP max
    WSSmin0.6 ± 0.90.4 ± 0.6.241.3 ± 2.00.4 ± 0.8<.001b<.001b
    WSSmax285.3 ± 216.1269.5 ± 183.11.00269.6 ± 324.5784.9 ± 2730.4.006b.05b
    WSSmean28.1 ± 26.822.3 ± 18.6.4929.3 ± 35.527.1 ± 36.8.28.81
    WSSnorm0.53 ± 0.400.44 ± 0.26.300.60 ± 0.390.50 ± 0.32.12.43
    SCI5.48 ± 10.875.54 ± 4.53.213.30 ± 3.956.74 ± 7.20<.001b<.001b
    LSA51.6 ± 33.050.9 ± 33.4.8148.7 ± 32.449.6 ± 32.0.721.00
    OSImax0.243 ± 0.1230.334 ± 0.115.008b0.181 ± 0.1340.332 ± 0.103<.001b<.001b
    OSImean0.012 ± 0.0100.014 ± 0.010.550.009 ± 0.0110.014 ± 0.010.005b.06
    Q0.80 ± 1.150.72 ± 0.85.790.23 ± 0.290.70 ± 0.62<.001b<.001b
    ICI0.72 ± 0.890.82 ± 0.80.660.24 ± 0.430.68 ± 0.57<.001b<.001b
    Vmax82.3 ± 62.580.8 ± 44.4.8861.9 ± 63.198.2 ± 81.0<.001b<.001b
    VE11.8 ± 10.110.1 ± 6.8.779.1 ± 8.910.9 ± 9.4.29.70
    SR259.6 ± 192.3229.2 ± 159.8.68339.6 ± 305.0246.1 ± 236.4.03b.18
    VO363.1 ± 284.9319.1 ± 225.8.70445.7 ± 421.7346.1 ± 345.6.09.38
    CORELEN1.481 ± 2.0142.501 ± 3.159.170.376 ± 0.5572.226 ± 2.144<.001b<.001b
    PODENT0.167 ± 0.1360.175 ± 0.074.330.137 ± 0.1210.192 ± 0.127.009b.08
    Asize0.594 ± 0.3310.713 ± 0.361.140.365 ± 0.1850.726 ± 0.282<.001b<.001b
    Nsize0.412 ± 0.1850.422 ± 0.147.750.306 ± 0.1270.423 ± 0.136<.001b<.001b
    AR0.956 ± 0.7551.176 ± 0.551.060.669 ± 0.4081.198 ± 0.609<.001b<.001b
    Distality–––0.444 ± 0.3450.612 ± 0.321<.008b.04b
    • Note:—LSA indicates percentage area under low WSS; SCI, shear concentration index; Vmax, maximum flow velocity; Q, aneurysm flow rate; ICI, inflow concentration index; norm, normalized; Asize, aneurysm maximum size; Nsize, neck maximum size; AR, aspect ratio (≤depth/neck size); VO, mean aneurysm vorticity; SR, shear rates; VE, mean aneurysm velocity; Distality, coordinate of vessel segment along the arterial tree.

    • ↵a Values are given as mean ± SD. P values correspond to univariate paired Wilcoxon rank sum tests. For ipsilateral aneurysms, mean and maximum P values of 100 randomly selected ruptured–unruptured pairs are given.

    • ↵b Significant difference (P < .05).

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American Journal of Neuroradiology: 38 (12)
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R. Doddasomayajula, B.J. Chung, F. Mut, C.M. Jimenez, F. Hamzei-Sichani, C.M. Putman, J.R. Cebral
Hemodynamic Characteristics of Ruptured and Unruptured Multiple Aneurysms at Mirror and Ipsilateral Locations
American Journal of Neuroradiology Dec 2017, 38 (12) 2301-2307; DOI: 10.3174/ajnr.A5397

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Hemodynamic Characteristics of Ruptured and Unruptured Multiple Aneurysms at Mirror and Ipsilateral Locations
R. Doddasomayajula, B.J. Chung, F. Mut, C.M. Jimenez, F. Hamzei-Sichani, C.M. Putman, J.R. Cebral
American Journal of Neuroradiology Dec 2017, 38 (12) 2301-2307; DOI: 10.3174/ajnr.A5397
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