The De Winter-like electrocardiogram pattern in inferior and lateral leads associated with left circumflex coronary artery occlusion

The aim of this report was to investigate coronary artery occlusion related to De Winter-like electrocardiogram (ECG) pattern. A patient admitted to Zhongshan Hospital who was diagnosed with acute coronary syndrome with De Winter-like ECG pattern was reviewed in our case report. In this case, we found that a De Winter-like ECG change in the inferior and lateral leads was associated with left circumflex coronary artery occlusion. After a timely reperfusion therapy, the symptom was obviously alleviated with a normalization of upsloping ST-segment. Doctors should be aware that De Winter-like ECG changes can also predict acute occlusion in any coronary artery, not only in the left anterior descending artery and right coronary artery but also in the left circumflex coronary artery.

[The clinical observation of sirolimus combined with calcineurin inhibitors for steroid-resistant/steroid-dependent extensive cGVHD]

Objective: To observe the efficacy and safety of sirolimus combined with calcineurin inhibitor (CNI) in the treatment of glucocorticoid resistant/dependent extensive chronic graft-versus-host disease (cGVHD) . Methods: A total of 27 patients with steroid-resistant/steroid-dependent extensive cGVHD from November 2015 to January 2019 were enrolled and given sirolimus capsules combined with cyclosporine or tacrolimus to observe the clinical efficacy and adverse events. Results: The median duration of medication was 14.2 months and the mean duration was 16.7 months. The median follow-up time was 20.1 months (12.9-46.1 months) . Following the 6-month follow-up, 3 cases achieved complete response (CR) and 12 cases partial response (PR) . The overall response rate (ORR) was 55.6% ; for progression-free survival (PFS) , PFS-6 reached 88.9% (24/27) , and for overall survival (OS) , OS-6 was 100% . At the 1-year follow-up, there were 5 cases of CR and 11 cases of PR, ORR was 59.3% , PFS-12 reached 62.9% (17/27) , and OS-12 was 100% . The subgroup analysis found that the program was more effective for cGVHD in male donors and the target organ analysis had an advantage in the treatment of oral cavity, skin, and liver rejection. Adverse events were observed: hyperlipidemia 11.1% , oral ulcer 7.4% , fungal infection 11.1% , liver injury 3.7% , renal insufficiency 0, and no new CMV and EB viremia. Conclusion: Sirolimus combined with calcineurin inhibitors is effective in treating steroid-resistant/steroid-dependent extensive cGVHD, especially because adverse reactions (renal toxicity, CMV, EBV infection) are low in number, which is suitable for long-term treatment of cGVHD.

Electrospun Yb-Doped In2O3 Nanofiber Field-Effect Transistors for Highly Sensitive Ethanol Sensors

Enhancing the reliability and sensitivity of gas sensors based on FETs has been of extensive concern for their practical application. However, few reports are available on nanofiber FET gas sensors fabricated by the electrospinning process. In this work, ethanol gas sensors based on Yb-doped In₂O₃ (InYbO) nanofiber FETs are fabricated by a simple and fast electrospinning method. The optimized In₂O₃ nanofiber FETs with a doping concentration of 4 mol % show a better electrical performance, including a high mobility of 6.67 cm²/Vs, an acceptable threshold voltage of 3.27 V, and a suitable on/off current ratio of 10⁷, especially the enhanced bias-stress stability. When employed in ethanol gas sensors, the gas sensors exhibit enhanced stability and improved sensitivity with a high response of 40-10 ppm, which is remarkably higher than that of previously reported ethanol gas sensors. Moreover, the InYbO nanofiber FET sensors also demonstrate a low limit of detection of 1 ppm and improved sensing performance ranging from sensitivity to the ability of selectivity. This work opens up a new prospect to achieve highly sensitive, selective, and reliable ethanol gas sensors using electrospun Yb-In₂O₃ nanofiber FETs with improved stability.

MiR-92 overexpression suppresses immune cell function in ovarian cancer via LATS2/YAP1/PD-L1 pathway

PURPOSE

Increasing evidence suggested that microRNA plays an important role in ovarian cancer. In this study, the role of miR-92 in ovarian cancer was investigated.

METHODS

In this study, miR-92 expression in clinical sample was evaluated, role of miR-92 was investigated in vitro, and underlying mechanism was investigated using Chip, co-IP, and western blot.

RESULTS

In this study, we show that miR-92 is overexpressed in ovarian cancer tissue compared with normal cancer tissue. Transfection of miR-92 increased proliferation of ovarian cancer cell, and increased migration capacity and colony formation were observed after miR-92 transfection; we found that expression of LATS2 was decreased by miR-92, and this was further confirmed by luciferase assay, which proved that miR-92 is targeting 3' of the endogenous LATS2 gene. Downregulation of LATS2 resulted in increased translocation of YAP1 and upregulation of PD-L1, which subsequently suppressed NK cell function and promoted T cell apoptosis. Moreover, co-transfection of YAP1-targeted shRNA could relieve miR-92-induced immune suppression effect. Mechanically, immunoprecipitation (IP) was used to show that LATS2 interacted with YAP1 and subsequently limited nuclear translocation of YAP1; chromatin immunoprecipitation (ChIP) was used to confirm that YAP1 could bind to enhancer region of PD-L1 to enhance transcription activity of PD-L1.

CONCLUSIONS

Our data revealed a novel mechanism which finally resulted in immune suppression in ovarian cancer.

Cardiovascular manifestations in severe and critical patients with COVID-19

Background

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) could cause virulent infection leading to Corona Virus Disease 2019 (COVID‐19)‐related pneumonia as well as multiple organ injuries.

Hypothesis

COVID‐19 infection may result in cardiovascular manifestations leading to worse clinical outcome.

Methods

Fifty four severe and critical patients with confirmed COVID‐19 were enrolled. Risk factors predicting the severity of COVID‐19 were analyzed.

Results

Of the 54 patients (56.1 ± 13.5 years old, 66.7% male) with COVID‐19, 39 were diagnosed as severe and 15 as critical cases. The occurrence of diabetes, the level of D‐dimer, inflammatory and cardiac markers in critical cases were significantly higher. Troponin I (TnI) elevation occurred in 42.6% of all the severe and critical patients. Three patients experienced hypotension at admission and were all diagnosed as critical cases consequently. Hypotension was found in one severe case and seven critical cases during hospitalization. Sinus tachycardia is the most common type of arrythmia and was observed in 23 severe patients and all the critical patients. Atrioventricular block and ventricular tachycardia were observed in critical patients at end stage while bradycardia and atrial fibrillation were less common. Mild pericardial effusion was observed in one severe case and five critical cases. Three critical cases suffered new onset of heart failure. Hypotension during treatment, severe myocardial injury and pericardial effusion were independent risk factors predicting the critical status of COVID‐19 infection.

Conclusion

This study has systemically observed the impact of COVID‐19 on cardiovascular system, including myocardial injury, blood pressure, arrythmia and cardiac function in severe and critical cases. Monitoring of vital signs and cardiac function of COVID‐19 patients and applying potential interventions especially for those with hypotension during treatment, severe myocardial injury or pericardial effusion, is of vital importance.

AB0132 ALTERATIONS IN PERIPHERAL T-CELLS AND B-CELLS SUBSETS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN’S SYNDROME UNDERGOING THERAPEUTIC PLASMA EXCHANGE OR IMMUNOADSORPTION

Background:

Systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SS) are systemic autoimmune diseases characterized by a broad spectrum of clinical manifestations and disease course. Alternative therapies such as therapeutic plasma exchange (TPE), immunoadsorption are recommended to the patients who lack a good response to standard therapy [1].

Objectives:

Our observational study was to explored whether abnormalities in T-cells, B-cells and their subtypes were present in the patients who had TPE or immunoadsorption in patients with SLE and SS compared with healthy controls (HC).

Methods:

Demographic, clinical variables and autoantibodies were recorded. Flow cytometry was used to establish the frequencies of lineage subsets. Monoclonal antibodies against 21 surface markers such as CD3, CD4, CD8, were used to distinguish and evaluate T-cells’ and B-cells’ subpopulation. SLE acvity was measured using systemic lupus erythematosus disease activity index (SLEDAI). Comparisons between subgroups were undertaken using paired T-test, Mann-Whitney U test and ANOVA.

Figure 1.

Altered expression of CD4+ T-cell subsets in the patients with SLE and SS after treated with plasma exchange or immunoadsorption

Results:

6 SS patients and 1 SLE patient underwent immune adsorption, while the other 5 SLE patients had plasma exchange all for three times. There was no significant difference among SLE, SS and HC in the proportion of T-cells and B-cells. The proportion of CD3-CD19+CD27+IgD+ B-cells were reduced in SLE, while CD3+CD4+CD25+CD127- T-cells were elevated in SS. The proportion of CD3+CD4+CD45RA+CCR7+T-cells were increased (p= 0.045), while CD3+CD4+CD25+CD127- T-cells were declined (p= 0.027) and CD3+CD4+CXCR5+PD-1+ T-cells went down after the therapies (p≤ 0.030). The proportion of CD3-CD19+IgD-IgM-CD27+CD38+ B-cells was also reduced after TPE or immunoadsorption (p= 0.032) with ANA titers and IgG decreasing dramatically. SLEDAI scores were reduced after the therapy in SLE patients.

Conclusion:

The T-cell and B-cell’s profiles were proved to have alteration after TPE or immunoadsorption which shed light on the complicated mechanisms of these relatively novel therapy in SLE and SS.

References:

[1]Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. ANN RHEUM DIS 2012;71:1771-1782.

Acknowledgments:

None.

Disclosure of Interests:

None declared

The impacts of gene polymorphisms on methotrexate in Chinese psoriatic patients

BACKGROUND

Methotrexate (MTX) is the first-line treatment for psoriasis in China. The metabolic processes of MTX include various proteins and genes. Previous studies have shown that gene polymorphisms had significant impacts on the efficacy of MTX. However, the influence of gene polymorphisms has not been reported in the Chinese psoriatic patients.

OBJECTIVE

The aim of this study was to verify the impacts of candidate genes polymorphisms on the effectiveness of MTX in a Chinese psoriatic population.

METHODS

In this study, we enrolled 259 psoriasis patients from two clinical centres. Each of them received MTX treatment at 7.5-15 mg/week for at least 8 weeks. Patients were stratified as responders and non-responders according to whether the Psoriasis Area and Severity Index score declined more than 75% (PASI75). According to previous reports, 16 single nucleotide polymorphisms (SNPs) were selected and genotyped for each patient using the Sequenom platform. Fisher's exact test, the chi-square test, Mann-Whitney tests and ANOVA analyses were used for statistical analysis.

RESULTS

Among 259 patients, there were 182 males and 77 females, 63 patients with psoriatic arthritis and 196 patients without arthritis phenotype, and the age of all patients ranged from 19 to 70 years (49.7 ± 13.6). The baseline PASI value of patients was 13.8 ± 8.5, and 33.2% of patients achieved a PASI75 response after MTX treatment. Patients carrying the ATP-binding cassette subfamily B member 1 gene (ABCB1) rs1045642 TT genotype were associated with more severe psoriasis skin lesion (P = 0.032). Furthermore, the ABCB1 rs1045642 TT genotype was found to be more frequent in non-responders (P = 0.017), especially in moderate-to-severe patients (P = 0.002) and patients without psoriatic arthritis (P = 0.026) after MTX treatment.

CONCLUSION

We have demonstrated for the first time that polymorphism of the ABCB1 rs1045642 TT genotype is predictive of a worse clinical response of skin lesions to MTX therapy in a Chinese psoriatic population.

A new quantitative mapping criterion to localize the ablation target of right ventricular outflow tract arrhythmias

PURPOSE

(1) To explore the electrophysiological characteristics of the bipolar and unipolar electrogram (UEGM) of ablation targets for RVOT arrhythmias. (2) To optimize the diagnostic criteria of RVOT arrhythmia ablation targets.

METHODS AND RESULTS

A consecutive series of 111 patients with RVOT arrhythmias who underwent radiofrequency catheter ablation (RFCA) were studied. The voltage of bipolar potential for ablation targets were evaluated by three-dimensional voltage mapping procedure. The max slope of the descending limb (MSDL)、local activation preceding time (LAPT), the interval of the descending limb (IDL) and the interval of MSDL (IMSDL) of the unipolar potential were then calculated and analyzed for successful targets(ST) and failed targets(FT)groups. Successful ablation was achieved in 102 patients and 9 patients failed. LAPT was higher in the ST group than that in FT group (30.0 ± 4.3 ms vs 22.8 ± 6.3 ms, P < 0.001). IMSDL was lower in the ST group than that in FT group (9.93 ± 6.32 ms vs 21.7 ± 16.1 ms, P < 0.001). IMSDL and LAPT have a predictive value for a ST (AUC 75% and 83.7%). The optimal cut off value for LAPT and IMSDL were 24.5 ms and 20 ms respectively. A better predictive value can be acquired when IMSDL and LAPT were used in combination (AUC 93.9%, Sensibility/Specificity 92.3%/84.2%).

CONCLUSION

A combined use of LAPT and IMSDL may be helpful as an additional criterion for ST judgement.

[Analysis of anxiety, depression and related factors in patients with chronic lumbocrural pain before minimally invasive surgery]

OBJECTIVE

To investigate anxiety and/or depression status of patients with chronic lumbocrural pain, and to further analyze related risk factors of anxiety and/or depression .

METHODS

Retrospective analysis of the medical data of patients who suffered from chronic lumbocrural pain caused by lumbar disc herniation and/or lumbar spinal stenosis and received minimally invasive surgery from March 2018 to April 2018. General data (including age, gender, education levels, past history, sleep order and medical insurance), numeric rating scale(NRS), Japanese Orthopedic Association(JOA) back pain scale and hospital anxiety and depression scale(HADS) were collected for analysis. The basic demographic data and clinic data were analyzed, possible related risk factors associated were analyzed by univariate analysis, and multivariate Logistic regression analysis was further used to find the relative independent risk factors and included all the predictive variables with P values less than 0.05 as covariates.

RESULTS

A total of 91 patients met the inclusion criteria and finished this study, the mean HADS score for anxiety was 8.1±4.2, 48(52.7%) respondents were screened positive for anxiety, while the rest 43(47.3%) patients had negative anxiety state, the mean HDDS score for depression was 6.9±4.9, 38(41.8%) respondents were screened positive for depression, and the rest 53(58.2%) patients were not depressed, and 56(61.5%) patients experienced anxiety or depression. There were significant difference in sleep disorder, JOA score and leg NRS score between the patients with and without anxiety(P<0.05), and the significant differences were also found in age, sleep disorder and JOA score between the patients with and without depression(P<0.05), Logistic regression analysis further showed that the JOA score and sleep disorder were risk factors for anxiety, and the JOA score was risk factor for depression.

CONCLUSION

Patients with chronic lumbocrural pain are often accompanied by anxiety and/or depression before minimally surgery, the low JOA score and sleep disturbance increased the risk of presenting anxiety, and the low JOA score increased the risk of developing depression. It is necessary to evaluate mental status and related risk factors before surgery.

Entanglement Hamiltonian of Many-Body Dynamics in Strongly Correlated Systems

A powerful perspective in understanding nonequilibrium quantum dynamics is through the time evolution of its entanglement content. Yet apart from a few guiding principles for the entanglement entropy, to date, much less is known about the refined characteristics of entanglement propagation. Here, we unveil signatures of the entanglement evolving and information propagating out of equilibrium, from the view of the entanglement Hamiltonian. We investigate quantum quench dynamics of prototypical Bose-Hubbard model using state-of-the-art numerical technique combined with conformal field theory. Before reaching equilibrium, it is found that a current operator emerges in the entanglement Hamiltonian, implying that entanglement spreading is carried by particle flow. In the long-time limit the subsystem enters a steady phase, evidenced by the dynamic convergence of the entanglement Hamiltonian to the expectation of a thermal ensemble. Importantly, the entanglement temperature in steady state is spatially independent, which provides an intuitive trait of equilibrium. These findings not only provide crucial information on how equilibrium statistical mechanics emerges in many-body dynamics, but also add a tool to exploring quantum dynamics from the perspective of the entanglement Hamiltonian.

Research on changes in cognitive function, β-amyloid peptide and neurotrophic factor in stroke patients

OBJECTIVE

To investigate the changes as well as the related mechanism in cognitive function and levels of serum β-amyloid peptide (Aβ) and brain-derived neurotrophic factor (BDNF) in stroke patients.

PATIENTS AND METHODS

A total of 30 patients with acute stroke treated in our hospital from June 2015 to September 2016 were selected as stroke group, while 30 volunteers during the same period were enrolled as control group. Changes in cognitive function of patients were evaluated using the Montreal Cognitive Assessment (MoCA) and mini-mental state examination (MMSE) before and after the treatment. At the same time, the concentrations of serum Aβ1-40 and BDNF were detected, and their correlations with the MMSE score were analyzed. Finally, levels of serum cyclic adenosine monophosphate (cAMP) and phosphorylated-cAMP-response element binding protein (p-CREB), and the phosphorylation level of Tau protein were detected by Western blotting.

RESULTS

MoCA and MMSE scores of patients in stroke group were significantly lower than those in control group (p < 0.01), and the scores were significantly higher in stroke patients after treatment than those before treatment (p < 0.01). Compared with those in control group, the serum Aβ1-40 concentration in patients in stroke group was significantly increased (p < 0.01), but the BDNF level was significantly decreased (p < 0.01). Compared with those before treatment, the serum Aβ1-40 concentration in patients was significantly decreased after treatment (p < 0.01), but the BDNF concentration was significantly increased (p < 0.01). Correlation analysis showed that the MMSE score was negatively correlated with the concentration of Aβ1-40 (r2 = 0.764, p < 0.01), but positively related to the level of BDNF (r2 = 0.827, p < 0.01). Compared with those in control group, the content of serum cAMP and p-CREB in stroke patients was significantly decreased (p < 0.01), but the expression of p-Tau was statistically increased (p < 0.01).

CONCLUSIONS

The cognitive function in stroke patients is impaired, with the rising content of serum Aβ1-40 and reduction of BDNF, the mechanism of which is related to the decrease of cAMP and p-CREB and the increase of p-Tau. This provides a theoretical basis for searching the new therapeutic targets and new drugs for stroke.

Dirac Spin Liquid on the Spin-1/2 Triangular Heisenberg Antiferromagnet

We study the spin liquid candidate of the spin-1/2 J_{1}-J_{2} Heisenberg antiferromagnet on the triangular lattice by means of density matrix renormalization group (DMRG) simulations. By applying an external Aharonov-Bohm flux insertion in an infinitely long cylinder, we find unambiguous evidence for gapless U(1) Dirac spin liquid behavior. The flux insertion overcomes the finite size restriction for energy gaps and clearly shows gapless behavior at the expected wave vectors. Using the DMRG transfer matrix, the low-lying excitation spectrum can be extracted, which shows characteristic Dirac cone structures of both spinon-bilinear and monopole excitations. Finally, we confirm that the entanglement entropy follows the predicted universal response under the flux insertion.

Temperature Dependence Of AOS Thin Film Nano Transistors For Medical Applications

Background

A novel temperature dependent amorphous nano oxide semiconductor (AOS) thin-film transistor (TFT) is reported here for the first time, which is vastly different from conventional behavior. In the literature, the threshold voltage of TFTs decreases with increasing temperature. Here, the threshold voltage increased at higher temperatures, which is different from previously reported results and was repeated on different samples.

Methods

Electrical experiments (such as I-V measurements and photoelectron spectrometer experiments) were performed in order to explain such behavior. Double sweeping gate voltage measurements were performed to investigate the mechanism for the temperature dependent behavior.

Results

It was found that there was a change of trap charge under thermal stress, which was released after the stress.

Conclusion

Non-Arrhenius behaviors (including a linear behavior) were obtained for the amorphous nano oxide thin-film transistors within 303~425 K, suggesting their potential to be adjusted by measurement processes and be applied as temperature sensors for numerous medical applications.

Protein restriction and succedent realimentation affecting ileal morphology, ileal microbial composition and metabolites in weaned piglets

Dietary protein restriction is one of the effective ways to reduce post-weaning diarrhoea and intestinal fermentation in piglets, but it may also reduce growth performance. The compensatory growth induced by subsequent protein realimentation may solve the issue. However, little research has been done on the impact of protein realimentation on the gut. In this study, the effects of protein restriction and realimentation on ileal morphology, ileal microbial composition and metabolites in weaned piglets were investigated. Thirty-six 28-day-old weaned piglets with an average body weight of 6.47 ± 0.04 kg were randomly divided into a control group and a treatment group. The CP level in the diet of the control group was 18.83% for the entire experimental period. The piglets in the treatment group were fed 13.05% CP between days 0 and 14 and restored to a diet of 18.83% CP for days 14 to 28. On day 14 and 28, six pigs from each group were sacrificed and sampled. It was found that the abundance of Lactobacillus and Salmonella in the ileal digesta was significantly lower in the treatment group than the control group on day 14, whereas the abundance of Clostridium sensu stricto 1, Streptococcus, Halomonas and Pseudomonas significantly increased in the ileal digesta of the treatment group on day 14 compared with the control group. In addition, reduced concentrations of lactic acid, total short-chain fatty acids (total SCFAs), total branched chain fatty acids, ammonia and impaired ileal morphology and mucosal barrier were observed in the treatment group on day 14. However, diarrhoea levels decreased in the treatment group throughout the experiment. During the succedent protein realimentation stage, the treatment group demonstrated compensatory growth. Compared with the control group, the treatment group showed increased abundance of Lactobacillus and reduced abundance of Salmonella, Halomonas and Pseudomonas in the ileum on day 28. The concentrations of lactic acid and total SCFAs increased significantly, whereas the concentration of ammonia remained at a lower level in the treatment group on day 28 compared with the control group. Overall, protein realimentation could improve ileal morphology and barrier functions and promote ileal digestive and absorptive functions. In conclusion, ileal microbial composition and metabolites could change according to dietary protein restriction and realimentation and eventually influence ileal morphology and barrier functions.

Combustion synthesis of electrospun LaInO nanofiber for high-performance field-effect transistors

One-dimensional semiconductor nanofibers are regarded as ideal materials for electronics due to their distinctive morphology and characteristics. In this work, La-doped indium oxide (LaInO) nanofibers are fabricated as the channel layer to reduce O vacancies and the density of interface trap states; this is clearly confirmed by investigating the stability under positive bias stress and the capacitance-voltage for field-effect transistors (FETs). The In₂O₃ nanofiber FETs optimized by doping with 5 mol% La exhibit excellent electrical performance with a mobility of 4.95 cm² V^-1 s^-1 and an on/off current ratio of 1.1 × 10⁸. In order to further enhance the electrical performance of LaInO nanofiber FETs, ZrAlO _x film, which has a high dielectric constant, is employed as the insulator for the LaInO nanofiber FETs. The LaInO nanofiber FETs with ZrAlO _x insulator have a high mobility of 13.5 cm² V^-1 s^-1. These findings clearly indicate the great promise of La-doped In₂O₃ nanofibers in future one-dimensional nanoelectronics.

Hemodynamic Analysis of Postoperative Rupture of Unruptured Intracranial Aneurysms after Placement of Flow-Diverting Stents: A Matched Case-Control Study

BACKGROUND AND PURPOSE

Postoperative rupture of intracranial aneurysm has been reported as a fatal complication after flow-diverter placement. We assessed several hemodynamic variables to explore risk factors in the postoperative rupture process.

MATERIALS AND METHODS

We enrolled 10 patients with intracranial aneurysms, treated with flow diverters between September 2014 and December 2018, who experienced postoperative aneurysm rupture (postoperative aneurysm rupture group). We matched these subjects 1:2 with 20 patients with postoperative unruptured (postoperative unruptured group) intracranial aneurysms based on clinical and morphologic factors. Using computational fluid dynamics, we assessed hemodynamic changes pre- and posttreatment between the 2 groups on a number of qualitative and quantitative parameters.

RESULTS

In the postoperative aneurysm rupture group, the proportion of patients with aneurysms with an unstable flow pattern increased to 60.0% after treatment, while the proportion in the postoperative unruptured group decreased to 20.0%, a significant difference between the 2 groups (P = .028). Energy loss in the postoperative unruptured group decreased after treatment but increased in the postoperative aneurysm rupture group. The reduction ratio of energy loss showed a significant difference between the 2 groups (22.73% ± 53.59% for postoperative unruptured versus -158.81% ± 183.95% for postoperative aneurysm rupture, P = .02). Other parameters and changes of pre- and posttreatment hemodynamic parameters showed no significant difference between 2 groups.

CONCLUSIONS

Compared with pretreatment, unstable flow pattern and higher energy loss after Pipeline Embolization Device placement for intracranial aneurysm may be the important hemodynamic risk factors related to delayed aneurysm rupture.