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Zhao Q, Pedroza A, Sharma D, Gu W, Dalal A, Weldy C, Jackson W, Li DY, Ryan Y, Nguyen T, Shad R, Palmisano BT, Monteiro JP, Worssam M, Berezwitz A, Iyer M, Shi H, Kundu R, Limbu L, Kim JB, Kundaje A, Fischbein M, Wirka R, Quertermous T, Cheng P. A cell and transcriptome atlas of the human arterial vasculature. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.10.612293. [PMID: 39314359 PMCID: PMC11419041 DOI: 10.1101/2024.09.10.612293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Vascular beds show different propensities for different vascular pathologies, yet mechanisms explaining these fundamental differences remain unknown. We sought to build a transcriptomic, cellular, and spatial atlas of human arterial cells across multiple different arterial segments to understand this phenomenon. We found significant cell type-specific segmental heterogeneity. Determinants of arterial identity are predominantly encoded in fibroblasts and smooth muscle cells, and their differentially expressed genes are particularly enriched for vascular disease-associated loci and genes. Adventitial fibroblast-specific heterogeneity in gene expression coincides with numerous vascular disease risk genes, suggesting a previously unrecognized role for this cell type in disease risk. Adult arterial cells from different segments cluster not by anatomical proximity but by embryonic origin, with differentially regulated genes heavily influenced by developmental master regulators. Non-coding transcriptomes across arterial cells contain extensive variation in lnc-RNAs expressed in cell type- and segment-specific patterns, rivaling heterogeneity in protein coding transcriptomes, and show enrichment for non-coding genetic signals for vascular diseases.
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Kim J, Zhang K, Canton G, Balu N, Meyer K, Saber R, Paydarfar D, Yuan C, Sacks MS. In Vivo Deformation of the Human Basilar Artery. Ann Biomed Eng 2024:10.1007/s10439-024-03605-x. [PMID: 39240472 DOI: 10.1007/s10439-024-03605-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 08/14/2024] [Indexed: 09/07/2024]
Abstract
An estimated 6.8 million people in the United States have an unruptured intracranial aneurysms, with approximately 30,000 people suffering from intracranial aneurysms rupture each year. Despite the development of population-based scores to evaluate the risk of rupture, retrospective analyses have suggested the limited usage of these scores in guiding clinical decision-making. With recent advancements in imaging technologies, artery wall motion has emerged as a promising biomarker for the general study of neurovascular mechanics and in assessing the risk of intracranial aneurysms. However, measuring arterial wall deformations in vivo itself poses several challenges, including how to image local wall motion and deriving the anisotropic wall strains over the cardiac cycle. To overcome these difficulties, we first developed a novel in vivo MRI-based imaging method to acquire cardiac gated images of the human basilar artery (BA) over the cardiac cycle. Next, complete BA endoluminal surfaces from each frame were segmented, producing high-resolution point clouds of the endoluminal surfaces. From these point clouds we developed a novel B-spline-based surface representation, then exploited the local support nature of B-splines to determine the local endoluminal surface strains. Results indicated distinct regional and temporal variations in BA wall deformation, highlighting the heterogeneous nature BA function. These included large circumferential strains (up to ∼ 20 % ), and small longitudinal strains, which were often contractile and out of phase with the circumferential strains patterns. Of particular interest was the temporal phase lag in the maximum circumferential perimeter length, which indicated that the BA deforms asynchronously over the cardiac cycle. In summary, the proposed method enabled local deformation analysis, allowing for the successful reproduction of local features of the BA, such as regional principal stretches, areal changes, and pulsatile motion. Integrating the proposed method into existing population-based scores has the potential to improve our understanding of mechanical properties of human BA and enhance clinical decision-making.
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Affiliation(s)
- Jaemin Kim
- James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Kaiyu Zhang
- Vascular Imaging Lab, Department of Radiology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Gador Canton
- Vascular Imaging Lab, Department of Radiology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Niranjan Balu
- Vascular Imaging Lab, Department of Radiology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Kenneth Meyer
- James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Reza Saber
- Department of Neurology, Dell School of Medicine, University of Texas, Austin, TX, USA
| | - David Paydarfar
- Department of Neurology, Dell School of Medicine, University of Texas, Austin, TX, USA
| | - Chun Yuan
- Vascular Imaging Lab, Department of Radiology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Michael S Sacks
- James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.
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Zhao Y, Zhang J, Yu H, Hou X, Zhang J. Noninvasive microvascular imaging in newborn rats using high-frequency ultrafast ultrasound. Neuroimage 2024; 297:120738. [PMID: 39009248 DOI: 10.1016/j.neuroimage.2024.120738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open
Abstract
Ultrasound imaging stands as the predominant modality for neonatal health assessment, with recent advancements in ultrafast Doppler (μDoppler) technology offering significant promise in fields such as neonatal brain imaging. Combining μDoppler with high-frequency ultrasound (HF-μDoppler) presents a potential efficient avenue to enhance in vivo microvascular imaging in small animals, notably newborn rats, a crucial preclinical animal model for neonatal disease and development research. It is necessary to verify the imaging performance of HF-μDoppler in preclinical trials. This study investigates the microvascular imaging capabilities of HF-μDoppler using a 30 MHz high-frequency linear array probe in newborn rats. Results demonstrate the clarity of cerebral microvascular imaging in rats aged 1 to 7 postnatal days, extending to whole-body microvascular imaging, encompassing the central nervous system, including the brain and spinal cord. In conclusion, HF-μDoppler technology emerges as a reliable imaging tool, offering a new perspective for preclinical investigations into neonatal diseases and development.
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Affiliation(s)
- Yunlong Zhao
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jiabin Zhang
- College of Future Technology, Peking University, Beijing, China.
| | - Hao Yu
- College of Engineering, Peking University, Beijing, China
| | - Xinlin Hou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; College of Engineering, Peking University, Beijing, China
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Hong J, Zhu W, He K, Chen X, Lu J, Li P. Ergodic speckle contrast optical coherence tomography velocimetry of rapid blood flow. OPTICS LETTERS 2024; 49:3600-3603. [PMID: 38950219 DOI: 10.1364/ol.523063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/27/2024] [Indexed: 07/03/2024]
Abstract
Visualizing a 3D blood flow velocity field through noninvasive imaging is crucial for analyzing hemodynamic mechanisms in areas prone to disorders. However, traditional correlation-based optical coherence tomography (OCT) velocimetry techniques have a maximum measurable flow velocity depending on the A-line rate. We presented the ergodic speckle contrast OCT (ESCOCT) to break the bottleneck in measuring the rapid blood flow velocity. It achieved a measurement of blood flow velocity ranging from 9.5 to 280 mm/s using a 100 kHz swept-source (SS) OCT based on 100 A-repeats scanning mode. Addressing the non-ergodic problem of temporal OCT signals by integrating more consecutive A-scans, ESCOCT can enable the estimation for lower velocity flows by increasing A-repeats. ESCOCT provided a wide dynamic range with no upper limit on measuring blood flow velocity with an adequate signal-to-noise ratio and improved the sensitivity and accuracy of the hemodynamic assessment.
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Subramanian V, Juhr D, Johnson LS, Yem JB, Giansanti P, Grumbach IM. Changes in the Proteome of the Circle of Willis during Aging Reveal Signatures of Vascular Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2024; 2024:4887877. [PMID: 38962180 PMCID: PMC11221951 DOI: 10.1155/2024/4887877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 04/22/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024]
Abstract
Approximately 70% of all strokes occur in patients over 65 years old, and stroke increases the risk of developing dementia. The circle of Willis (CoW), the ring of arteries at the base of the brain, links the intracerebral arteries to one another to maintain adequate cerebral perfusion. The CoW proteome is affected in cerebrovascular and neurodegenerative diseases, but changes related to aging have not been described. Here, we report on a quantitative proteomics analysis comparing the CoW from five young (2-3-month-old) and five aged male (18-20-month-old) mice using gene ontology (GO) enrichment, ingenuity pathway analysis (IPA), and iPathwayGuide tools. This revealed 242 proteins that were significantly dysregulated with aging, among which 189 were upregulated and 53 downregulated. GO enrichment-based analysis identified blood coagulation as the top biological function that changed with age and integrin binding and extracellular matrix constituents as the top molecular functions. Consistent with these findings, iPathwayGuide-based impact analysis revealed associations between aging and the complement and coagulation, platelet activation, ECM-receptor interaction, and metabolic process pathways. Furthermore, IPA analysis revealed the enrichment of 97 canonical pathways that contribute to inflammatory responses, as well as 59 inflammation-associated upstream regulators including 39 transcription factors and 20 cytokines. Thus, aging-associated changes in the CoW proteome in male mice demonstrate increases in metabolic, thrombotic, and inflammatory processes.
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Affiliation(s)
- Vikram Subramanian
- Abboud Cardiovascular Research CenterDepartment of Internal MedicineCarver College of MedicineUniversity of Iowa, Iowa City, USA
| | - Denise Juhr
- Abboud Cardiovascular Research CenterDepartment of Internal MedicineCarver College of MedicineUniversity of Iowa, Iowa City, USA
| | - Lydia S. Johnson
- Abboud Cardiovascular Research CenterDepartment of Internal MedicineCarver College of MedicineUniversity of Iowa, Iowa City, USA
| | - Justin B. Yem
- Abboud Cardiovascular Research CenterDepartment of Internal MedicineCarver College of MedicineUniversity of Iowa, Iowa City, USA
| | - Piero Giansanti
- Bavarian Center for Biomolecular Mass Spectrometry (BayBioMS@MRI)Technical University of Munich, Munich, Germany
| | - Isabella M. Grumbach
- Abboud Cardiovascular Research CenterDepartment of Internal MedicineCarver College of MedicineUniversity of Iowa, Iowa City, USA
- Free Radical and Radiation Biology ProgramDepartment of Radiation OncologyCarver College of MedicineUniversity of Iowa, Iowa City, USA
- Iowa City VA Healthcare System, Iowa City, IA, USA
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Cevik Y, Onan HB, Erdem H, Kizilkanat ED, Yucel SP, Oguz O. Investigation of the morphometric characteristics of internal carotid artery between sexes and in patients with intracranial aneurysms. Surg Radiol Anat 2024; 46:859-869. [PMID: 38630269 DOI: 10.1007/s00276-024-03351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/16/2024] [Indexed: 06/09/2024]
Abstract
PURPOSE The purpose of this study is to investigate the morphometric properties of the internal carotid artery (ICA) by measuring the diameters and angles of its segments and exploring variations related to sex and the presence of aneurysms. METHODS Digital subtraction angiography (DSA) images were utilized from 130 aneurysm patients and 75 non-aneurysm individuals to create 3D ICA models using 3D Slicer software. Segment diameters were measured via Autodesk Meshmixer 3.5.474 and angles were evaluated using ImageJ software. RESULTS In total, DSA images of 130 aneurysm patients and 75 individuals with normally reported carotid systems were evaluated. It was found that the intracranial aneurysms (IAs) were predominantly formed on the anterior cerebral artery (ACA) in males (%43), whereas in females IAs were frequently localized in the C6 segment (31.7%) and middle cerebral artery (MCA) (30.2%). In the control group, the evaluation of gender differences in segment diameters and angles revealed that males had significantly larger C4 and C5 segment diameters (4.62 vs. 4.32 mm and 4.41 vs. 4.09 mm, respectively) and a greater C6 angle (146.9° vs. 139.7°) compared to females. Comparisons between patients with an aneurysm at the anterior cerebral artery (ACA) and the control group revealed that the ACA group had wider diameters in the C1 (4.88 vs. 4.53 mm), C3 (4.65 vs. 4.4 mm), C5 (4.51 vs. 4.25 mm), and ACA (2.36 vs. 2.06 mm) segments. Additionally, the ACA group had wider angles in the ACA (104.1° vs. 94.1°) and C6 segments (147.7° vs. 143.3°), whereas the control group exhibited wider angles in the middle cerebral artery (MCA) segment (141.5° vs. 135.5°) compared to the ACA aneurysm group. Patients with anterior cerebral artery (ACA) aneurysms exhibited larger diameters in C1, C3, C5, C6, and ACA segments compared to the control group. Additionally, while the control group had larger MCA angle, patients with ACA aneurysms had larger angles in C6 segment and ACA. CONCLUSION Our results demonstrated that formation of aneurysms is affected by anatomical configuration of the ICA as well as sex characteristics, particularly regarding the ACA and MCA bifurcation angles, which showed associations with aneurysms in the respective branches.
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Affiliation(s)
- Yigit Cevik
- Department of Anatomy, Faculty of Medicine, Cukurova University, Adana, 01330, Turkey.
| | - Hasan Bilen Onan
- Department of Radiology, Faculty of Medicine, Cukurova University, Adana, 01330, Turkey
| | - Huseyin Erdem
- Department of Anatomy, Faculty of Medicine, Cukurova University, Adana, 01330, Turkey
| | | | - Sevinc Puren Yucel
- Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, 01330, Turkey
| | - Ozkan Oguz
- Department of Anatomy, Faculty of Medicine, Cukurova University, Adana, 01330, Turkey
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Li W, Wang C, Wang Y, Zhao Y, Yang X, Liu X, Liu J. A model with multiple intracranial aneurysms: possible hemodynamic mechanisms of aneurysmal initiation, rupture and recurrence. Chin Neurosurg J 2024; 10:13. [PMID: 38711139 PMCID: PMC11071235 DOI: 10.1186/s41016-024-00364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/26/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Hemodynamic factors play an important role in aneurysm initiation, growth, rupture, and recurrence, while the mechanism of the hemodynamic characteristics is still controversial. A unique model of multiple aneurysms (initiation, growth, rupture, and recurrence) is helpful to avoids the confounders and further explore the possible hemodynamic mechanisms of aneurysm in different states. METHODS We present a model with multiple aneurysms, and including the states of initiation, growth, rupture, and recurrence, discuss the proposed mechanisms, and describe computational fluid dynamic model that was used to evaluate the likely hemodynamic effect of different states of the aneurysms. RESULTS The hemodynamic analysis suggests that high flow impingement and high WSS distribution at normal parent artery was found before aneurysmal initiation. The WSS distribution and flow velocity were decreased in the new sac after aneurysmal growth. Low WSS was the risk hemodynamic factor for aneurysmal rupture. High flow concentration region on the neck plane after coil embolization still marked in recanalized aneurysm. CONCLUSIONS Associations have been identified between high flow impingement and aneurysm recanalization, while low WSS is linked to the rupture of aneurysms. High flow concentration and high WSS distribution at normal artery associated with aneurysm initiation and growth, while after growth, the high-risk hemodynamics of aneurysm rupture was occurred, which is low WSS at aneurysm dome.
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Affiliation(s)
- Wenqiang Li
- Department of Interventional Neuroradiology and Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Beijing, China
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chao Wang
- Department of Interventional Neuroradiology and Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Beijing, China
| | - Yanmin Wang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yapeng Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinjian Yang
- Department of Interventional Neuroradiology and Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Beijing, China
| | - Xianzhi Liu
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Jian Liu
- Department of Interventional Neuroradiology and Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Beijing, China.
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Fu Y, Bian X, Zou R, Jin R, Leng X, Fan F, Wei S, Cui X, Xiang J, Guan S. Hemodynamic alterations of flow diverters on aneurysms at the fetal posterior communicating artery: A simulation study using CFD to compare the surpass streamline, pipeline flex, and tubridge devices. J Neuroradiol 2024; 51:74-81. [PMID: 37442272 DOI: 10.1016/j.neurad.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023]
Abstract
PURPOSE Traditional flow diverters (FDs) for treating aneurysms at the fetal posterior communicating artery are unsatisfactory. Surpass Streamline is a novel FD with different mesh characteristics; however, the outcomes for such aneurysms remain unclear. This study aimed to compare hemodynamic alterations induced by Surpass Streamline, Pipeline Flex, and Tubridge devices and explore possible strategies for aneurysms at the fetal posterior communicating artery. METHODS Two simulated aneurysms (Case 1, Case 2) were constructed from digital subtraction angiography (DSA). The three FDs were virtually deployed, and hemodynamic analysis based on computational fluid dynamics was performed. Hemodynamic parameters, including the sac-averaged velocity magnitude (Velocity), high-flow volume (HFV), and wall shear stress (WSS), were compared between each FD and the untreated model (control). Surpass Streamline was performed in real life for two aneurysms and the clinical outcomes were collected for analysis. RESULTS Compared to the control, the Surpass resulted in the most significant reduction in flow. In Case 1, the Velocity, HFV, and WSS were reduced by 51.6%, 78.1%, and 64.3%, respectively. In Case 2, the Velocity, HFV, and WSS were reduced by 48.0%, 81.1%, and 65.3%, respectively. Tubridge showed slightly larger changes in hemodynamic parameters than Pipeline. In addition, our analysis suggested that metal coverage was correlated with the WSS, Velocity, and HFV. The postoperative DSA showed that the aneurysm was nearly occluded in Case 1 and decreased in Case 2. CONCLUSION Compared to that with the Pipeline and Tubridge, the Surpass resulted in the greatest reduction in hemodynamic parameters and might be effective for aneurysms at the fetal posterior communicating artery. Virtual FD deployment and computational fluid dynamics analysis may be used to predict the treatment outcomes.
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Affiliation(s)
- Yu Fu
- Department of Neurointervention Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Bian
- ArteryFlow Technology Co., Ltd., Hangzhou, China
| | - Rong Zou
- ArteryFlow Technology Co., Ltd., Hangzhou, China
| | - Rongbo Jin
- ArteryFlow Technology Co., Ltd., Hangzhou, China
| | | | - Feng Fan
- Department of Neurointervention Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Sen Wei
- Department of Neurointervention Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xuan Cui
- Department of Neurointervention Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Sheng Guan
- Department of Neurointervention Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Guo H, Liu JF, Li CH, Wang JW, Li H, Gao BL. Greater hemodynamic stresses initiate aneurysms on major cerebral arterial bifurcations. Front Neurol 2023; 14:1265484. [PMID: 37900605 PMCID: PMC10601459 DOI: 10.3389/fneur.2023.1265484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Objective To retrospectively investigate the hemodynamic stresses in initiating aneurysm formation on major cerebral arterial bifurcations with computational fluid dynamics (CFD) analysis. Methods The cerebral 3D angiographic data of major cerebral arterial bifurcations of the internal carotid, middle cerebral, anterior cerebral, and basilar arteries in 80 patients harboring bifurcation aneurysms and 80 control subjects with no aneurysms were retrospectively collected for the CFD analysis of hemodynamic stresses associated with aneurysm formation. Results Bifurcation angles at major bifurcations in all patients were significantly positively (P < 0.001) correlated with the age. At the center of direct flow impingement (CDFI) on the bifurcation wall, total pressure was the highest but dropped rapidly toward the branches. Wall shear stress, dynamic pressure, strain rate, and vorticity were lowest at the CDFI but they increased quickly toward the branches. The bifurcation angle was significantly (P < 0.001) enlarged in patients with bifurcation aneurysms than those without them, for all major arterial bifurcations. Most aneurysms leaned toward the smaller arterial branch or the arterial branch that formed a smaller angle with the parent artery, where the hemodynamic stresses increased significantly (P < 0.05), compared with those on the contralateral arterial branch forming a larger angle with the parent artery. Following the aneurysm development, all the hemodynamic stresses on the aneurysm dome decreased significantly (P < 0.001) compared with those at the initiation site on the bifurcation wall after virtual aneurysm removal. With the decrease of bifurcation angles, all the hemodynamic stresses decreased. Conclusion The formation of intracranial aneurysms on major intracranial arterial bifurcations is significantly associated with locally abnormally augmented hemodynamic stresses, which must be reduced.
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Affiliation(s)
| | | | - Cong-Hui Li
- Department of Neurosurgery, The First Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
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Hindenes LB, Ingebrigtsen T, Isaksen JG, Håberg AK, Johnsen LH, Herder M, Mathiesen EB, Vangberg TR. Anatomical variations in the circle of Willis are associated with increased odds of intracranial aneurysms: The Tromsø study. J Neurol Sci 2023; 452:120740. [PMID: 37517271 DOI: 10.1016/j.jns.2023.120740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/06/2023] [Accepted: 07/23/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE Studies on patients suggest an association between anatomical variations in the Circle of Willis (CoW) and intracranial aneurysms (IA), but it is unclear whether this association is present in the general population. In this cross-sectional population study, we investigated the associations between CoW anatomical variations and IA. METHODS We included 1667 participants from a population sample with 3 T MRI time-of-flight angiography (40-84 years, 46.5% men). Saccular IAs were defined as protrusions in the intracranial arteries ≥2 mm, while variants of the CoW were classified according to whether segments were missing or hypoplastic (< 1 mm). We used logistic regression, adjusting for age and IA risk factors, to assess whether participants with incomplete CoW variants had a greater prevalence of IA and whether participants with specific incomplete variants had a greater prevalence of IA. RESULTS Participants with an incomplete CoW had an increased prevalence of IA (OR, 2.3 [95% CI 1.05-5.04]). This was mainly driven by the variant missing all three communicating arteries (OR, 4.2 [95% CI 1.7-1 0.3]) and the variant missing the P1 segment of the posterior cerebral artery (OR, 3.6 [95% CI 1.2-10.1]). The combined prevalence of the two variants was 15.4% but accounted for 28% of the IAs. CONCLUSION The findings suggest that an incomplete CoW is associated with an increased risk of IA for adults in the general population.
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Affiliation(s)
- Lars B Hindenes
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; PET Imaging Center, University Hospital of North Norway, Tromsø, Norway
| | - Tor Ingebrigtsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology, and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
| | - Jørgen G Isaksen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology, and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
| | - Asta K Håberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Liv-Hege Johnsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Marit Herder
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Torgil R Vangberg
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; PET Imaging Center, University Hospital of North Norway, Tromsø, Norway.
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Mehri A, Sotoodeh Ghorbani S, Farhadi-Babadi K, Rahimi E, Barati Z, Taherpour N, Izadi N, Shahbazi F, Mokhayeri Y, Seifi A, Fallah S, Feyzi R, Etemed K, Hashemi Nazari SS. Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study. J Intensive Care Med 2023; 38:825-837. [PMID: 36976873 PMCID: PMC10051011 DOI: 10.1177/08850666231166344] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 03/09/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023]
Abstract
Objectives: This study aims to investigate the risk factors associated with severity and death from COVID-19 through a systematic review and meta-analysis of the published documents in Iran. Methods: A systematic search was performed based on all articles indexed in Scopus, Embase, Web of Science (WOS), PubMed, and Google Scholar in English and Scientific Information Database (SID) and Iranian Research Institute for Information Science and Technology (IRA)NDOC indexes in Persian. To assess quality, we used the Newcastle Ottawa Scale. Publication bias was assessed using Egger's tests. Forest plots were used for a graphical description of the results. We used HRs, and ORs reported for the association between risk factors and COVID-19 severity and death. Results: Sixty-nine studies were included in the meta-analysis, of which 62 and 13 had assessed risk factors for death and severity, respectively. The results showed a significant association between death from COVID-19 and age, male gender, diabetes, hypertension, cardiovascular disease (CVD), cerebrovascular disease, chronic kidney disease (CKD), Headache, and Dyspnea. We observed a significant association between increased white blood cell (WBC), decreased Lymphocyte, increased blood urea nitrogen (BUN), increased creatinine, vitamin D deficiency, and death from COVID-19. There was only a significant relationship between CVD and disease severity. Conclusion: It is recommended that the predictive risk factors of COVID-19 severity and death mentioned in this study to be used for therapeutic and health interventions, to update clinical guidelines and determine patients' prognoses.
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Affiliation(s)
- Ahmad Mehri
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Sotoodeh Ghorbani
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kosar Farhadi-Babadi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Rahimi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Barati
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Taherpour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shahbazi
- Department of Epidemiology, School of Health, Hamadan University of Medical Sciences Hamadan, Iran
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Yaser Mokhayeri
- Department of Infectious Disease, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Seifi
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Saeid Fallah
- Department of Epidemiology, School of Public Health and Safety, Prevention of Cardiovascular Disease Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rezvan Feyzi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Koorosh Etemed
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Saeed Hashemi Nazari
- Department of Epidemiology, School of Public Health and Safety, Prevention of Cardiovascular Disease Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Patil K, Komatsu F, Tanaka R, Sasaki K, Yamada Y, Okubo M, Katayama T, Miyatani K, Chemate S, Satoh T, Kato Y. Computational Fluid Dynamics Analysis of Trigeminal Neuralgia Associated with the Vertebral Artery: A Report of Two Cases. Asian J Neurosurg 2023; 18:626-630. [PMID: 38152508 PMCID: PMC10749829 DOI: 10.1055/s-0043-1771324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
Abstract
Trigeminal neuralgia is a nerve disorder that causes unilateral severe facial pain. The clinical features of trigeminal neuralgia are agonizing, paroxysmal, anticipated in one or more divisions of the trigeminal nerve, with repetitive bursts of a few seconds, exacerbated by cutaneous stimuli. Microvascular decompression is proven effective, resulting in a positive outcome. Here, we report two cases of trigeminal neuralgia associated with the vertebral artery, who underwent endoscopic microvascular decompression. This case report aims to show the benefit of computational fluid dynamics evaluation of the neurovascular contact and its effect on change in wall shear stress magnitude of the offending vertebral artery after surgical management with microvascular decompression.
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Affiliation(s)
- Kapil Patil
- Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan
| | - Fuminari Komatsu
- Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan
| | - Riki Tanaka
- Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan
| | - Kento Sasaki
- Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan
| | - Yasuhiro Yamada
- Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan
| | - Mai Okubo
- Department of Nurse Practitioner, Fujita Health University Hospital, Aichi, Japan
| | - Tomoka Katayama
- Department of Nurse Practitioner, Fujita Health University Hospital, Aichi, Japan
| | - Kyosuke Miyatani
- Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan
| | - Sachin Chemate
- Department of Neurosurgery, Noble Hospitals, Pune, Maharashtra, India
| | - Toru Satoh
- Department of Neurosurgery, Satoh Neurosurgical Hospital, Matsunaga, Fukuyama, Japan
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan
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13
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Shields A, Setlur Nagesh SV, Rajagopal K, Bednarek DR, Rudin S, Chivukula VK. Application of 1,000 fps High-Speed Angiography to In-Vitro Hemodynamic Evaluation of Left Ventricular Assist Device Outflow Graft Configurations. ASAIO J 2023; 69:756-765. [PMID: 37140988 PMCID: PMC10524133 DOI: 10.1097/mat.0000000000001948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Left ventricular assist device (LVAD)-induced hemodynamics are characterized by fast-moving flow with large variations in velocity, making quantitative assessments difficult with existing imaging methods. This study demonstrates the ability of 1,000 fps high-speed angiography (HSA) to quantify the effect of the surgical implantation angle of a LVAD outflow graft on the hemodynamics within the ascending aorta in vitro . High-speed angiography was performed on patient-derived, three-dimensional-printed optically opaque aortic models using a nonsoluble contrast media, ethiodol, as a flow tracer. Outflow graft configuration angles of 45° and 90° with respect to the central aortic axis were considered. Projected velocity distributions were calculated from the high-speed experimental sequences using two methods: a physics-based optical flow algorithm and tracking of radio-opaque particles. Particle trajectories were also used to evaluate accumulated shear stress. Results were then compared with computational fluid dynamics (CFD) simulations to confirm the results of the high-speed imaging method. Flow patterns derived from HSA coincided with the impingement regions and recirculation zones formed in the aortic root as seen in the CFD for both graft configurations. Compared with the 45° graft, the 90° configuration resulted in 81% higher two-dimensional-projected velocities (over 100 cm/s) along the contralateral wall of the aorta. Both graft configurations suggest elevated accumulated shear stresses along individual trajectories. Compared with CFD simulations, HSA successfully characterized the fast-moving flow and hemodynamics in each LVAD graft configuration in vitro , demonstrating the potential utility of this technology as a quantitative imaging modality.
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Affiliation(s)
- Allison Shields
- Medical Physics Program, University at Buffalo, Buffalo,
New York, USA
- Canon Stroke and Vascular Research Center, University at
Buffalo, Buffalo, New York, USA
| | - Swetadri Vasan Setlur Nagesh
- Medical Physics Program, University at Buffalo, Buffalo,
New York, USA
- Canon Stroke and Vascular Research Center, University at
Buffalo, Buffalo, New York, USA
| | - Keshava Rajagopal
- Division of Cardiac Surgery, Department of Surgery, Sidney
Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania,
USA
| | - Daniel R. Bednarek
- Medical Physics Program, University at Buffalo, Buffalo,
New York, USA
- Canon Stroke and Vascular Research Center, University at
Buffalo, Buffalo, New York, USA
| | - Stephen Rudin
- Medical Physics Program, University at Buffalo, Buffalo,
New York, USA
- Canon Stroke and Vascular Research Center, University at
Buffalo, Buffalo, New York, USA
| | - Venkat Keshav Chivukula
- Department of Biomedical Engineering, Florida Institute of
Technology, Melbourne, Florida, USA
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14
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Liu Y, Jiang G, Wang X, An X, Wang F. The relationship between geometry and hemodynamics of the stenotic carotid artery based on computational fluid dynamics. Clin Neurol Neurosurg 2023; 231:107860. [PMID: 37390570 DOI: 10.1016/j.clineuro.2023.107860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/17/2023] [Accepted: 06/24/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE The purpose of this work was to investigate the relationship between the geometric factors and the hemodynamics of the stenotic carotid artery. METHODS We retrospectively reviewed data of patients with carotid stenosis (40%-95%). The Navier-Stokes equations were solved using ANSYS CFX 18.0. Correlation analysis was based on Spearman's test. Geometric variables (p < 0.1 in the univariate analysis) were entered into the logistical regression. A receiver-operating characteristics analysis was used to detect hemodynamically significant lesions. RESULTS 81 patients (96 arteries) were evaluated. The logistic regression analysis revealed that the translesional pressure ratio was significantly correlated with the stenosis degree (OR = 1.147, p < 0.001) and the angle between internal carotid artery and external carotid artery (angle γ) (OR = 0.933, p = 0.01). The translesional wall shear stress ratio was significantly correlated with stenosis degree (OR = 1.094, p < 0.001), lesion length (OR = 0.873, p = 0.01), lumen area of internal carotid artery (OR = 0.867, p = 0.002), and lumen area of common carotid artery (OR = 1.058, p = 0.01). For predicting low translesional pressure ratio, the AUC was 0.71 (p < 0.001) for angle γ, and was 0.87 (p < 0.001) for stenosis degree. For predicting high translesional wall shear stress ratio, the AUC was 0.62 (p = 0.04) for lumen area of internal carotid artery, and was 0.77 (p < 0.001) for stenosis degree. CONCLUSIONS Apart from stenosis degree, other geometric characteristics of lesions may also have an influence on hemodynamics of the stenotic carotid artery.
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Affiliation(s)
- Yongsheng Liu
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guinan Jiang
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xuwen Wang
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiangbo An
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Feng Wang
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
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15
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Kjeldsberg HA, Sundnes J, Valen-Sendstad K. A verified and validated moving domain computational fluid dynamics solver with applications to cardiovascular flows. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3703. [PMID: 37020156 DOI: 10.1002/cnm.3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/06/2023] [Accepted: 03/20/2023] [Indexed: 06/07/2023]
Abstract
Computational fluid dynamics (CFD) in combination with patient-specific medical images has been used to correlate flow phenotypes with disease initiation, progression and outcome, in search of a prospective clinical tool. A large number of CFD software packages are available, but are typically based on rigid domains and low-order finite volume methods, and are often implemented in massive low-level C++ libraries. Furthermore, only a handful of solvers have been appropriately verified and validated for their intended use. Our goal was to develop, verify and validate an open-source CFD solver for moving domains, with applications to cardiovascular flows. The solver is an extension of the CFD solver Oasis, which is based on the finite element method and implemented using the FEniCS open source framework. The new solver, named OasisMove, extends Oasis by expressing the Navier-Stokes equations in the arbitrary Lagrangian-Eulerian formulation, which is suitable for handling moving domains. For code verification we used the method of manufactured solutions for a moving 2D vortex problem, and for validation we compared our results against existing high-resolution simulations and laboratory experiments for two moving domain problems of varying complexity. Verification results showed that the L 2 error followed the theoretical convergence rates. The temporal accuracy was second-order, while the spatial accuracy was second- and third-order using ℙ 1 / ℙ 1 and ℙ 2 / ℙ 1 finite elements, respectively. Validation results showed good agreement with existing benchmark results, by reproducing lift and drag coefficients with less than 1% error, and demonstrating the solver's ability to capture vortex patterns in transitional and turbulent-like flow regimes. In conclusion, we have shown that OasisMove is an open-source, accurate and reliable solver for cardiovascular flows in moving domains.
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Affiliation(s)
- Henrik A Kjeldsberg
- Department of Computational Physiology, Simula Research Laboratory, Oslo, Norway
| | - Joakim Sundnes
- Department of Computational Physiology, Simula Research Laboratory, Oslo, Norway
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16
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Sache A, Reymond P, Brina O, Jung B, Farhat M, Vargas MI. Near-wall hemodynamic parameters quantification in in vitro intracranial aneurysms with 7 T PC-MRI. MAGMA (NEW YORK, N.Y.) 2023; 36:295-308. [PMID: 37072539 PMCID: PMC10140017 DOI: 10.1007/s10334-023-01082-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Wall shear stress (WSS) and its derived spatiotemporal parameters have proven to play a major role on intracranial aneurysms (IAs) growth and rupture. This study aims to demonstrate how ultra-high field (UHF) 7 T phase contrast magnetic resonance imaging (PC-MRI) coupled with advanced image acceleration techniques allows a highly resolved visualization of near-wall hemodynamic parameters patterns in in vitro IAs, paving the way for more robust risk assessment of their growth and rupture. MATERIALS AND METHODS We performed pulsatile flow measurements inside three in vitro models of patient-specific IAs using 7 T PC-MRI. To this end, we built an MRI-compatible test bench, which faithfully reproduced a typical physiological intracranial flow rate in the models. RESULTS The ultra-high field 7 T images revealed WSS patterns with high spatiotemporal resolution. Interestingly, the high oscillatory shear index values were found in the core of low WSS vortical structures and in flow stream intersecting regions. In contrast, maxima of WSS occurred around the impinging jet sites. CONCLUSIONS We showed that the elevated signal-to-noise ratio arising from 7 T PC-MRI enabled to resolve high and low WSS patterns with a high degree of detail.
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Affiliation(s)
- Antoine Sache
- Department of Mechanical Engineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Philippe Reymond
- Division of Neuroradiology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Olivier Brina
- Division of Neuroradiology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Bernd Jung
- Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mohamed Farhat
- Department of Mechanical Engineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Maria Isabel Vargas
- Division of Neuroradiology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
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17
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Wang H, Shen L, Zhao C, Liu S, Wu G, Wang H, Wang B, Zhu J, Du J, Gong Z, Chai C, Xia S. The incomplete circle of Willis is associated with vulnerable intracranial plaque features and acute ischemic stroke. J Cardiovasc Magn Reson 2023; 25:23. [PMID: 37020230 PMCID: PMC10077703 DOI: 10.1186/s12968-023-00931-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 03/13/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND The circle of Willis (CoW) plays a significant role in intracranial atherosclerosis (ICAS). This study investigated the relationship between different types of CoW, atherosclerosis plaque features, and acute ischemic stroke (AIS). METHODS We investigated 97 participants with AIS or transient ischemic attacks (TIA) underwent pre- and post-contrast 3T vessel wall cardiovascular magnetic resonance within 7 days of the onset of symptoms. The culprit plaque characteristics (including enhancement grade, enhancement ratio, high signal in T1, irregularity of plaque surface, and normalized wall index), and vessel remodeling (including arterial remodeling ratio and positive remodeling) for lesions were evaluated. The anatomic structures of the anterior and the posterior sections of the CoW (A-CoW and P-CoW) were also evaluated. The plaque features were compared among them. The plaque features were also compared between AIS and TIA patients. Finally, univariate and multivariate regression analysis was performed to evaluate the independent risk factors for AIS. RESULT Patients with incomplete A-CoW showed a higher plaque enhancement ratio (P = 0.002), enhancement grade (P = 0.01), and normalized wall index (NWI) (P = 0.018) compared with the patients with complete A-CoW. A higher proportion of patients with incomplete symptomatic P-CoW demonstrated more culprit plaques with high T1 signals (HT1S) compared with those with complete P-CoW (P = 0.013). Incomplete A-CoW was associated with a higher enhancement grade of the culprit plaques [odds ratio (OR):3.84; 95% CI: 1.36-10.88, P = 0.011], after adjusting for clinical risk factors such as age, sex, smoking, hypertension, hyperlipemia, and diabetes mellitus. Incomplete symptomatic P-CoW was associated with a higher probability of HT1S (OR:3.88; 95% CI: 1.12-13.47, P = 0.033), after adjusting for clinical risk factors such as age, sex, smoking, hypertension, hyperlipemia, and diabetes mellitus. Furthermore, an irregularity of the plaque surface (OR: 6.24; 95% CI: 2.25-17.37, P < 0.001), and incomplete symptomatic P-CoW (OR: 8.03, 95% CI: 2.43-26.55, P = 0.001) were independently associated with AIS. CONCLUSIONS This study demonstrated that incomplete A-CoW was associated with enhancement grade of the culprit plaque, and incomplete symptomatic side P-CoW was associated with the presence of HT1S of culprit plaque. Furthermore, an irregularity of plaque surface and incomplete symptomatic side P-CoW were associated with AIS.
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Affiliation(s)
- Huiying Wang
- The School of Medicine, Nankai University, Tianjin, 300071, China
| | - Lianfang Shen
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China
| | - Chenxi Zhao
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China
| | - Song Liu
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Gemuer Wu
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - Huapeng Wang
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China
| | - Beini Wang
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, 100102, China
| | - Jixiang Du
- Department of Neurology, School of Medicine, Tianjin First Central Hospital, Nankai University, Tianjin, 300192, China
| | - Zhongying Gong
- Department of Neurology, School of Medicine, Tianjin First Central Hospital, Nankai University, Tianjin, 300192, China.
| | - Chao Chai
- Department of Radiology, School of Medicine, Tianjin First Central Hospital, Nankai University, Tianjin, 300192, China.
- Tianjin Institute of Imaging Medicine, Tianjin, 300192, China.
| | - Shuang Xia
- Department of Radiology, School of Medicine, Tianjin First Central Hospital, Nankai University, Tianjin, 300192, China.
- Tianjin Institute of Imaging Medicine, Tianjin, 300192, China.
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18
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Lebas H, Boutigny A, Maupu C, Salfati J, Orset C, Mazighi M, Bonnin P, Boulaftali Y. Imaging Cerebral Arteries Tortuosity and Velocities by Transcranial Doppler Ultrasound Is a Reliable Assessment of Brain Aneurysm in Mouse Models. STROKE (HOBOKEN, N.J.) 2023; 3:e000476. [PMID: 37496732 PMCID: PMC10368188 DOI: 10.1161/svin.122.000476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/11/2022] [Accepted: 10/28/2022] [Indexed: 07/28/2023]
Abstract
Background During the past few decades, several pathophysiological processes contributing to intracranial aneurysm (IA) rupture have been identified, including irregular IA shape, altered hemodynamic stress within the IA, and vessel wall inflammation. The use of preclinical models of IA and imaging tools is paramount to better understand the underlying disease mechanisms. Methods We used 2 established mouse models of IA, and we analyzed the progression of the IA by magnetic resonance imaging, transcranial Doppler, and histology. Results In both models of IA, we observed, by transcranial Doppler, a significant decrease of the blood velocities and wall shear stress of the internal carotid arteries. We also observed the formation of tortuous arteries in both models that were correlated with the presence of an aneurysm as confirmed by magnetic resonance imaging and histology. A high grade of tortuosity is associated with a significant decrease of the mean blood flow velocities and a greater artery dilation. Conclusions Transcranial Doppler is a robust and convenient imaging method to evaluate the progression of IA. Detection of decreased blood flow velocities and increased tortuosity can be used as reliable indicators of IA.
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Affiliation(s)
- Héloïse Lebas
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
| | - Alexandre Boutigny
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
- Service de Physiologie Clinique Explorations FonctionnellesAP‐HPHôpital Lariboisière–F WidalParisFrance
| | - Clémence Maupu
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
| | - Jonas Salfati
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
| | - Cyrille Orset
- UMR‐S U1237 “Physiopathology and Imaging of Neurological Disorders,”Centre CYCERONCaenFrance
| | - Mikael Mazighi
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
- Département de Neuroradiologie Interventionnelle de la Fondation Rothschild et Département de NeurologieHôpital LariboisièreParisFrance
| | - Philippe Bonnin
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
- Service de Physiologie Clinique Explorations FonctionnellesAP‐HPHôpital Lariboisière–F WidalParisFrance
| | - Yacine Boulaftali
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
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19
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Rahma AG, Abdelhamid T. Hemodynamic and fluid flow analysis of a cerebral aneurysm: a CFD simulation. SN APPLIED SCIENCES 2023. [DOI: 10.1007/s42452-023-05276-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AbstractIn this study, we investigate the hemodynamics parameters and their impact on the aneurysm rupture. The simulations are performed on an ideal (benchmark) and realistic model for the intracranial aneurysm that appears at the anterior communicating artery. The realistic geometry was reconstructed from patient-specific cerebral arteries. The computational fluid dynamics simulations are utilized to investigate the hemodynamic parameters such as flow recirculation, wall shear stress, and wall pressure. The boundary conditions are measured from the patient using ultrasonography. The solution of the governing equations is obtained by using the ANSYS-FLUENT 19.2 package. The CFD results indicate that the flow recirculation appears in the aneurysms zone. The effect of the flow recirculation on the bulge hemodynamics wall parameters is discussed to identify the rupture zone.
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20
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Yi H, Yang Z, Johnson M, Bramlage L, Ludwig B. Developing an in vitro validated 3D in silico internal carotid artery sidewall aneurysm model. Front Physiol 2022; 13:1024590. [PMID: 36605897 PMCID: PMC9810024 DOI: 10.3389/fphys.2022.1024590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction: Direct quantification of hemodynamic factors applied to a cerebral aneurysm (CA) remains inaccessible due to the lack of technologies to measure the flow field within an aneurysm precisely. This study aimed to develop an in vitro validated 3D in silico patient-specific internal carotid artery sidewall aneurysm (ICASA) model which can be used to investigate hemodynamic factors on the CA pathophysiology. Methods: The validated ICASA model was developed by quantifying and comparing the flow field using particle image velocimetry (PIV) measurements and computational fluid dynamics (CFD) simulations. Specifically, the flow field characteristics, i.e., blood flowrates, normalized velocity profiles, flow streamlines, and vortex locations, have been compared at representative time instants in a cardiac pulsatile period in two designated regions of the ICASA model, respectively. One region is in the internal carotid artery (ICA) inlet close to the aneurysm sac, the other is across the middle of the aneurysmal sac. Results and Discussion: The results indicated that the developed computational fluid dynamics model presents good agreements with the results from the parallel particle image velocimetry and flowrate measurements, with relative differences smaller than 0.33% in volumetric flow rate in the ICA and relative errors smaller than 9.52% in averaged velocities in the complex aneurysmal sac. However, small differences between CFD and PIV in the near wall regions were observed due to the factors of slight differences in the 3D printed model, light reflection and refraction near arterial walls, and flow waveform uncertainties. The validated model not only can be further employed to investigate hemodynamic factors on the cerebral aneurysm pathophysiology statistically, but also provides a typical model and guidance for other professionals to evaluate the hemodynamic effects on cerebral aneurysms.
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Affiliation(s)
- Hang Yi
- Department of Mechanical and Materials Engineering, Wright State University, Dayton, OH, United States
| | - Zifeng Yang
- Department of Mechanical and Materials Engineering, Wright State University, Dayton, OH, United States
| | - Mark Johnson
- Department of Mechanical and Materials Engineering, Wright State University, Dayton, OH, United States
| | - Luke Bramlage
- Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
| | - Bryan Ludwig
- Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
- Division of NeuroInterventional Surgery, Department of Neurology, Wright State University/Premier Health—Clinical Neuroscience Institute, Dayton, OH, United States
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21
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Rahma AG, Yousef K, Abdelhamid T. Blood flow CFD simulation on a cerebral artery of a stroke patient. SN APPLIED SCIENCES 2022. [DOI: 10.1007/s42452-022-05149-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Abstract
The purpose of this paper is to conduct a numerical simulation of the stroke patient's cerebral arteries and investigate the flow parameters due to the presence of stenosis. The computational fluid dynamics (CFD) simulations are based on simplified and realistic cerebral artery models. The seven simplified models (benchmarks) include straight cylindrical vessels with idealized stenosis with variable d/D (0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1). The realistic model of the cerebral artery is based on magnetic resonance imaging (MRI) for patient-specific cerebral arteries. The simulation for the realistic model of the cerebral artery is performed at boundary conditions measured by ultrasonography of the input and the output flow profiles (velocity and pressure). The obtained CFD results of the benchmarks are validated with actual data from the literature. Furthermore, a previous vascular contraction is assumed to be exist and the effect of this contraction area ratio on the blood flow regime is discussed and highlighted. Furthermore, CFD results show that a certain vascular contraction area critically affects the blood flow which shows increasing the wall shear stress WSS at the stenosis site. An increase in the blood velocity and vortex appears after the contraction zone, this lead to vessel occlusion and strokes.
Article highlights
The pressure drop across the arterial contraction is reduced when the area ratio d/D is increased.
In some cases, the vortex can prevent blood flow from crossing, this leads to vessel occlusion especially at low d/D
The WSS near the contraction area is high. Increasing the WSS can cause embolism that leads to lead to vessel occlusion.
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22
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Yi H, Yang Z, Johnson M, Bramlage L, Ludwig B. Hemodynamic characteristics in a cerebral aneurysm model using non-Newtonian blood analogues. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2022; 34:103101. [PMID: 36212224 PMCID: PMC9533395 DOI: 10.1063/5.0118097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
This study aims to develop an experimentally validated computational fluid dynamics (CFD) model to estimate hemodynamic characteristics in cerebral aneurysms (CAs) using non-Newtonian blood analogues. Blood viscosities varying with shear rates were measured under four temperatures first, which serves as the reference for the generation of blood analogues. Using the blood analogue, particle image velocimetry (PIV) measurements were conducted to quantify flow characteristics in a CA model. Then, using the identical blood properties in the experiment, CFD simulations were executed to quantify the flow patterns, which were used to compare with the PIV counterpart. Additionally, hemodynamic characteristics in the simplified Newtonian and non-Newtonian models were quantified and compared using the experimentally validated CFD model. Results showed the proposed non-Newtonian viscosity model can predict blood shear-thinning properties accurately under varying temperatures and shear rates. Another developed viscosity model based on the blood analogue can well represent blood rheological properties. The comparisons in flow characteristics show good agreements between PIV and CFD, demonstrating the developed CFD model is qualified to investigate hemodynamic factors within CAs. Furthermore, results show the differences of absolute values were insignificant between Newtonian and non-Newtonian fluids in the distributions of wall shear stress (WSS) and oscillatory shear index (OSI) on arterial walls. However, not only does the simplified Newtonian model underestimate WSS and OSI in most regions of the aneurysmal sac, but it also makes mistakes in identifying the high OSI regions on the sac surface, which may mislead the hemodynamic assessment on the pathophysiology of CAs.
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Affiliation(s)
- Hang Yi
- Department of Mechanical and Material Engineering, Wright State University, 3640 Colonel Glenn Hwy., Dayton, Ohio 45435, USA
| | - Zifeng Yang
- Department of Mechanical and Material Engineering, Wright State University, 3640 Colonel Glenn Hwy., Dayton, Ohio 45435, USA
| | - Mark Johnson
- Department of Mechanical and Material Engineering, Wright State University, 3640 Colonel Glenn Hwy., Dayton, Ohio 45435, USA
| | - Luke Bramlage
- Boonshoft School of Medicine, Wright State University, Dayton, Ohio 45435, USA
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Patalano P. An Oscillatory Shear Index-Based Model to Describe Progressive Carotid Artery Stenosis. Vasc Endovascular Surg 2022; 57:26-34. [PMID: 36083843 DOI: 10.1177/15385744221116837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and aims: This study describes and demonstrates the applicability of a novel in silico method for modeling progressive carotid artery stenosis using the oscillatory shear index (OSI) as the basis of stenosis. Methods: Three-dimensional reconstructions of 11 carotid arteries were generated using patient-derived magnetic resonance angiography and duplex ultrasound data. Computational fluid dynamic simulations were sequentially generated following computational stenosis assessment, and corresponding changes in OSI were observed and used as measure of morphological stabilization. Results: 6 carotid models showed progressive stenosis with statistically significant increases in regions of high OSI (OSI >.2, P < .05) with eventual carotid occlusion in 1 of the cases. Three models remained free or nearly free of increased OSI, whereas 1 model showed an overall decrease in high OSI regions (P < .05) and another trended in that direction but did not achieve statistical significance (P = .145). Conclusions: To our knowledge, this is the first computational model describing progressive stenosis in any peripheral artery including the carotid. Taken together, this study provides a novel framework for computational hemodynamic investigations on progressive atherosclerosis in the carotid artery.
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Affiliation(s)
- Peter Patalano
- 12296New York University School of Medicine, New York, NY, USA
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24
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Zhou J, Li J, Qin S, Liu J, Lin Z, Xie J, Zhang Z, Chen R. High-resolution cerebral blood flow simulation with a domain decomposition method and verified by the TCD measurement. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 224:107004. [PMID: 35841853 DOI: 10.1016/j.cmpb.2022.107004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/24/2022] [Accepted: 07/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND An efficient and accurate blood flow simulation can be useful for understanding many vascular diseases. Accurately resolving the blood flow velocity based on patient-specific geometries and model parameters is still a major challenge because of complex geomerty and turbulence issues. In addition, obtaining results in a short amount of computing time is important so that the simulation can be used in the clinical environment. In this work, we present a parallel scalable method for the patient-specific blood flow simulation with focuses on its parallel performance study and clinical verification. METHODS We adopt a fully implicit unstructured finite element method for a patient-specific simulation of blood flow in a full precerebral artery. The 3D artery is constructed from MRI images, and a parallel Newton-Krylov method preconditioned with a two-level domain decomposition method is adopted to solve the large nonlinear system discretized from the time-dependent 3D Navier-Stokes equations in the artery with an integral outlet boundary condition. The simulated results are verified using the clinical data measured by transcranial Doppler ultrasound, and the parallel performance of the algorithm is studied on a supercomputer. RESULTS The simulated velocity matches the clinical measured data well. Other simulated blood flow parameters, such as pressure and wall shear stress, are within reasonable ranges. The results show that the parallel algorithm scales up to 2160 processors with a 49% parallel efficiency for solving a problem with over 20 million unstructured elements on a supercomputer. For a standard cerebral blood flow simulation case with approximately 4 million finite elements, the calculation of one cardiac cycle can be finished within one hour with 1000 processors. CONCLUSION The proposed method is able to perform high-resolution 3D blood flow simulations in a patient-specific full precerebral artery within an acceptable time, and the simulated results are comparable with the clinical measured data, which demonstrates its high potential for clinical applications.
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Affiliation(s)
- Jie Zhou
- School of Mathematics and Statistics, Changsha University of Science and Technology, Changsha, China
| | - Jing Li
- School of Mathematics and Statistics, Changsha University of Science and Technology, Changsha, China
| | - Shanlin Qin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
| | - Jia Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zeng Lin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jian Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Rongliang Chen
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Shenzhen Key Laboratory for Exascale Engineering and Scientific Computing, Shenzhen, China.
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25
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Effects of Pulsatile Flow Rate and Shunt Ratio in Bifurcated Distal Arteries on Hemodynamic Characteristics Involved in Two Patient-Specific Internal Carotid Artery Sidewall Aneurysms: A Numerical Study. Bioengineering (Basel) 2022; 9:bioengineering9070326. [PMID: 35877376 PMCID: PMC9311626 DOI: 10.3390/bioengineering9070326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 01/08/2023] Open
Abstract
The pulsatile flow rate (PFR) in the cerebral artery system and shunt ratios in bifurcated arteries are two patient-specific parameters that may affect the hemodynamic characteristics in the pathobiology of cerebral aneurysms, which needs to be identified comprehensively. Accordingly, a systematic study was employed to study the effects of pulsatile flow rate (i.e., PFR−I, PFR−II, and PFR−III) and shunt ratio (i.e., 75:25 and 64:36) in bifurcated distal arteries, and transient cardiac pulsatile waveform on hemodynamic patterns in two internal carotid artery sidewall aneurysm models using computational fluid dynamics (CFD) modeling. Numerical results indicate that larger PFRs can cause higher wall shear stress (WSS) in some local regions of the aneurysmal dome that may increase the probability of small/secondary aneurysm generation than under smaller PFRs. The low WSS and relatively high oscillatory shear index (OSI) could appear under a smaller PFR, increasing the potential risk of aneurysmal sac growth and rupture. However, the variances in PFRs and bifurcated shunt ratios have rare impacts on the time-average pressure (TAP) distributions on the aneurysmal sac, although a higher PFR can contribute more to the pressure increase in the ICASA−1 dome due to the relatively stronger impingement by the redirected bloodstream than in ICASA−2. CFD simulations also show that the variances of shunt ratios in bifurcated distal arteries have rare impacts on the hemodynamic characteristics in the sacs, mainly because the bifurcated location is not close enough to the sac in present models. Furthermore, it has been found that the vortex location plays a major role in the temporal and spatial distribution of the WSS on the luminal wall, varying significantly with the cardiac period.
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Shen Y, Molenberg R, Bokkers RPH, Wei Y, Uyttenboogaart M, van Dijk JMC. The Role of Hemodynamics through the Circle of Willis in the Development of Intracranial Aneurysm: A Systematic Review of Numerical Models. J Pers Med 2022; 12:jpm12061008. [PMID: 35743791 PMCID: PMC9225067 DOI: 10.3390/jpm12061008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The role of regional hemodynamics in the intracranial aneurysmal formation, growth, and rupture has been widely discussed based on numerical models over the past decades. Variation of the circle of Willis (CoW), which results in hemodynamic changes, is associated with the aneurysmal formation and rupture. However, such correlation has not been further clarified yet. The aim of this systematic review is to investigate whether simulated hemodynamic indices of the CoW are relevant to the formation, growth, or rupture of intracranial aneurysm. Methods: We conducted a review of MEDLINE, Web of Science, and EMBASE for studies on the correlation between hemodynamics indices of the CoW derived from numerical models and intracranial aneurysm up to December 2020 in compliance with PRISMA guidelines. Results: Three case reports out of 1046 publications met our inclusion and exclusion criteria, reporting 13 aneurysms in six patients. Eleven aneurysms were unruptured, and the state of the other two aneurysms was unknown. Wall shear stress, oscillatory shear index, von-Mises tension, flow velocity, and flow rate were reported as hemodynamic indices. Due to limited cases and significant heterogeneity between study settings, meta-analysis could not be performed. Conclusion: Numerical models can provide comprehensive information on the cerebral blood flow as well as local flow characteristics in the intracranial aneurysm. Based on only three case reports, no firm conclusion can be drawn regarding the correlation between hemodynamic parameters in the CoW derived from numerical models and aneurysmal formation or rupture. Due to the inherent nature of numerical models, more sensitive analysis and rigorous validations are required to determine its measurement error and thus extend their application into clinical practice for personalized management. Prospero registration number: CRD42021125169.
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Affiliation(s)
- Yuanyuan Shen
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Y.S.); (R.M.)
| | - Rob Molenberg
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Y.S.); (R.M.)
| | - Reinoud P. H. Bokkers
- Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (R.P.H.B.); (M.U.)
| | - Yanji Wei
- Engineering and Technology Institute Groningen, Faculty of Science & Engineering, University of Groningen, 9747 AG Groningen, The Netherlands;
| | - Maarten Uyttenboogaart
- Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (R.P.H.B.); (M.U.)
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - J. Marc C. van Dijk
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Y.S.); (R.M.)
- Correspondence:
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27
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Rostam-Alilou AA, Jarrah HR, Zolfagharian A, Bodaghi M. Fluid-structure interaction (FSI) simulation for studying the impact of atherosclerosis on hemodynamics, arterial tissue remodeling, and initiation risk of intracranial aneurysms. Biomech Model Mechanobiol 2022; 21:1393-1406. [PMID: 35697948 DOI: 10.1007/s10237-022-01597-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 12/11/2022]
Abstract
The biomechanical and hemodynamic effects of atherosclerosis on the initiation of intracranial aneurysms (IA) are not yet clearly discovered. Also, studies for the observation of hemodynamic variation due to atherosclerotic stenosis and its impact on arterial remodeling and aneurysm genesis remain a controversial field of vascular engineering. The majority of studies performed are relevant to computational fluid dynamic (CFD) simulations. CFD studies are limited in consideration of blood and arterial tissue interactions. In this work, the interaction of the blood and vessel tissue because of atherosclerotic occlusions is studied by developing a fluid and structure interaction (FSI) analysis for the first time. The FSI presents a semi-realistic simulation environment to observe how the blood and vessels' structural interactions can increase the accuracy of the biomechanical study results. In the first step, many different intracranial vessels are modeled for an investigation of the biomechanical and hemodynamic effects of atherosclerosis in arterial tissue remodeling. Three physiological conditions of an intact artery, the artery with intracranial atherosclerosis (ICAS), and an atherosclerotic aneurysm (ACA) are employed in the models with required assumptions. Finally, the obtained outputs are studied with comparative and statistical analyses according to the intact model in a normal physiological condition. The results show that existing occlusions in the cross-sectional area of the arteries play a determinative role in changing the hemodynamic behavior of the arterial segments. The undesirable variations in blood velocity and pressure throughout the vessels increase the risk of arterial tissue remodeling and aneurysm formation.
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Affiliation(s)
- Ali A Rostam-Alilou
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK
| | - Hamid R Jarrah
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK
| | - Ali Zolfagharian
- School of Engineering, Deakin University, Geelong, 3216, Australia
| | - Mahdi Bodaghi
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK.
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28
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The Cerebral Arterial Wall in the Development and Growth of Intracranial Aneurysms. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12125964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A considerable number of people harbor intracranial aneurysms (IA), which is a focal or segmental disease of the arterial wall. The pathophysiologic mechanisms of IAs formation, growth, and rupture are complex. The mechanism also differs with respect to the type of aneurysm. In broad aspects, aneurysms may be considered a disease of the vessel wall. In addition to the classic risk factors and the genetic/environmental conditions, altered structural and pathologic events along with the interaction of the surrounding environment and luminal flow dynamics contribute to the aneurysm’s development and growth. In this review, we have tried to simplify the complex interaction of a multitude of events in relation to vessel wall in the formation and growth of IAs.
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29
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Ultrafast two-photon fluorescence imaging of cerebral blood circulation in the mouse brain in vivo. Proc Natl Acad Sci U S A 2022; 119:e2117346119. [PMID: 35648820 PMCID: PMC9191662 DOI: 10.1073/pnas.2117346119] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
SignificanceCharacterizing blood flow by tracking individual red blood cells as they move through vessels is essential for understanding vascular function. With high spatial resolution, two-photon fluorescence microscopy is the method of choice for imaging blood flow at the cellular level. However, its application is limited to a low flow speed regimen in anesthetized animals by its slow focus scanning mechanism. Using an ultrafast scanning module, we demonstrated two-photon fluorescence imaging of blood flow at 1,000 two-dimensional frames and 1,000,000 one-dimensional line scans per second in the brains of awake mice. These ultrafast measurements enabled us to study hemodynamic and fluid mechanical regimens beyond the reach of conventional methods.
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30
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Yu H, Li Y, Feng Y, Zhang L, Yao Z, Liu Z, Gao W, Chen Y, Xie S. Enhanced Arterial Spin Labeling Magnetic Resonance Imaging of Cerebral Blood Flow of the Anterior and Posterior Circulations in Patients With Intracranial Atherosclerotic Stenosis. Front Neurosci 2022; 15:823876. [PMID: 35250438 PMCID: PMC8891638 DOI: 10.3389/fnins.2021.823876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 12/24/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives This study analyzed differences in the mean cerebral blood flow (mCBF) and arterial transit time (ATT) of the anterior and posterior circulations between patients with intracranial atherosclerotic stenosis (ICAS) and control subjects. We also investigated the correlation between ATT and mCBF in the two groups, and evaluated whether the blood flow velocity of the extracranial carotid/vertebral arteries can influence mCBF. Methods A total of 32 patients with ICAS were prospectively enrolled at the Radiology Department of the China-Japan Friendship Hospital between November 2020 and September 2021. All patients had extensive arterial stenosis, with 17 having cerebral arterial stenosis in the anterior circulation and 15 in the posterior circulation. Thirty-two healthy subjects were enrolled as a control group. Enhanced arterial spin labeling (eASL) imaging was performed using a 3.0-T GE magnetic resonance imaging scanner, and all patients underwent carotid and vertebral Doppler ultrasound examinations. CereFlow software was used for post-processing of the eASL data, to obtain cerebral perfusion parameters such as mCBF and ATT. Independent samples t-tests were used to analyze and compare mCBF and ATT of the anterior circulation (frontal lobe, parietal lobe, and insula) and posterior circulation (occipital lobe, cerebellum) between the patient and control groups. The relationships of ATT and mCBF in the two groups were evaluated with Pearson’s correlation. The blood flow velocity of the extracranial internal carotid/vertebral arteries, including the peak systolic velocity (PSV), end diastolic velocity (EDV), mean PSV (mPSV), and mean EDV (mEDV), was compared between the control and study groups using t-tests. Multiple linear regression analysis was then applied to determine the factors associated with mCBF in the two groups. Results The mCBFs of the anterior and posterior circulations in the patient group were lower than those of the control group. The ATTs in the patient group were all significantly longer than those of the control group (p < 0.05). Except for the insula in the control group, significant correlations were found between ATT and mCBF in all other investigated locations in the two groups (p < 0.05). The blood flow velocity of the extracranial internal carotid/vertebral arteries differed significantly between the control and patient groups (p < 0.05). The multiple linear regression analysis revealed that in patients with ICAS, mPSV of the vertebral arteries and local ATT correlated with mCBF of the occipital lobes and the cerebellum, respectively (p < 0.05). In contrast, there was no significant correlation within the anterior circulation (frontal lobes, parietal lobes, and insula). Conclusion There was a significant relationship between ATT and mCBF in patients with ICAS. Extracranial blood flow may influence intracranial hemodynamics in the posterior circulation in patients with ICAS. The maintenance of extracranial blood flow is of great significance in the preservation of intracranial hemodynamics.
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Affiliation(s)
- Hongwei Yu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yangchen Li
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Yibo Feng
- Department of Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Linwei Zhang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Zeshan Yao
- AnImageTech, Beijing Co., Ltd, Beijing, China
| | - Zunjing Liu
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Wenwen Gao
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Yue Chen
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Sheng Xie
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Sheng Xie,
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Wang H, Balzani D, Vedula V, Uhlmann K, Varnik F. On the Potential Self-Amplification of Aneurysms Due to Tissue Degradation and Blood Flow Revealed From FSI Simulations. Front Physiol 2021; 12:785780. [PMID: 34955893 PMCID: PMC8709128 DOI: 10.3389/fphys.2021.785780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Tissue degradation plays a crucial role in the formation and rupture of aneurysms. Using numerical computer simulations, we study the combined effects of blood flow and tissue degradation on intra-aneurysm hemodynamics. Our computational analysis reveals that the degradation-induced changes of the time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) within the aneurysm dome are inversely correlated. Importantly, their correlation is enhanced in the process of tissue degradation. Regions with a low TAWSS and a high OSI experience still lower TAWSS and higher OSI during degradation. Furthermore, we observed that degradation leads to an increase of the endothelial cell activation potential index, in particular, at places experiencing low wall shear stress. These findings are robust and occur for different geometries, degradation intensities, heart rates and pressures. We interpret these findings in the context of recent literature and argue that the degradation-induced hemodynamic changes may lead to a self-amplification of the flow-induced progressive damage of the aneurysmal wall.
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Affiliation(s)
- Haifeng Wang
- Theory and Simulation of Complex Fluids, Department of Scale-Bridging Thermodynamic and Kinetic Simulation, Interdisciplinary Center for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Bochum, Germany
| | - Daniel Balzani
- Department of Civil and Environmental Engineering, Chair of Continuum Mechanics, Ruhr-Universität Bochum, Bochum, Germany
| | - Vijay Vedula
- Department of Mechanical Engineering, Columbia University in the City of New York, New York, NY, United States
| | - Klemens Uhlmann
- Department of Civil and Environmental Engineering, Chair of Continuum Mechanics, Ruhr-Universität Bochum, Bochum, Germany
| | - Fathollah Varnik
- Theory and Simulation of Complex Fluids, Department of Scale-Bridging Thermodynamic and Kinetic Simulation, Interdisciplinary Center for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Bochum, Germany
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32
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Malek AM, Hippelheuser JE, Lauric A. Vortex formation and associated aneurysmogenic transverse rotational shear stress near the apex of wide-angle cerebral bifurcations. J Neurosurg 2021:1-12. [PMID: 34715656 DOI: 10.3171/2021.6.jns204385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Aneurysm formation preferentially occurs at the site of wide-angle cerebral arterial bifurcations, which were recently shown to have a high longitudinal positive wall shear stress (WSS) gradient that promotes aneurysm formation. The authors sought to explore the other components of the hemodynamic environment that are altered with increasing bifurcation angle in the apical region and the effects of these components on WSS patterns on the vessel wall that may modulate aneurysm genesis and progression. METHODS Parametric models of symmetrical and asymmetrical bifurcations were created with increasing bifurcation angles (45°-240°), and 3D rotational angiography models of 13 middle cerebral artery (MCA) bifurcations (7 aneurysmal, 6 controls) were analyzed using computational fluid dynamics. For aneurysmal bifurcations, the aneurysm was digitally removed to uncover hemodynamics at the apex. WSS vectors along cross-sectional planes distal to the bifurcation apex were decomposed as orthogonal projections to the cut plane into longitudinal and transverse (tangential to the cross-sectional plane) components. Transverse rotational WSS (TRWSS) and TRWSS gradients (TRWSSGs) were sampled and evaluated at the apex and immediately distal from the apex. RESULTS In parametric models, increased bifurcation angle was associated with transverse flow vortex formation with emergence of an associated apical high TRWSS with highly aneurysmogenic positive TRWSSGs. While TRWSS decayed rapidly away from the apex in narrow-angle bifurcations, it remained greatly elevated for many radii downstream in aneurysm-prone wider bifurcations. In asymmetrical bifurcations, TRWSS was higher on the aneurysm-prone daughter vessel associated with the wider angle. Patient-derived models with aneurysmal bifurcations had wider angles (149.33° ± 12.56° vs 98.17° ± 8.67°, p < 0.001), with significantly higher maximum TRWSS (1.37 ± 0.67 vs 0.48 ± 0.23 Pa, p = 0.01) and TRWSSG (1.78 ± 0.92 vs 0.76 ± 0.50 Pa/mm, p = 0.03) compared to control nonaneurysmal bifurcations. CONCLUSIONS Wider vascular bifurcations are associated with a novel and to the authors' knowledge previously undescribed transverse component rotational wall shear stress associated with a positive (aneurysmogenic) spatial gradient. The resulting hemodynamic insult, demonstrated in both parametric models and patient-based anatomy, is noted to decay rapidly away from the protection of the medial pad in healthy narrow-angle bifurcations but remain elevated distally downstream of wide-angle aneurysm-prone bifurcations. This TRWSS serves as a new contribution to the hemodynamic environment favoring aneurysm formation and progression at wide cerebral bifurcations and may have clinical implications favoring interventions that reduce bifurcation angle.
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Affiliation(s)
- Adel M Malek
- 1Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts
| | - James E Hippelheuser
- 1Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts
| | - Alexandra Lauric
- 1Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts
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Kancheva AK, Velthuis BK, Ruigrok YM. Imaging markers of intracranial aneurysm development: A systematic review. J Neuroradiol 2021; 49:219-224. [PMID: 34634299 DOI: 10.1016/j.neurad.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/14/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Imaging markers of intracranial aneurysm (IA) development are not well established. PURPOSE To provide an overview of imaging markers of IA development. METHODS A systematic search of PubMed and Embase up to December 1st 2020 using predefined criteria. Thirty-six studies met our inclusion criteria. We performed a quantitative summary of the included studies. RESULTS We found converging evidence for A1 segment asymmetry as an anatomical marker of anterior communicating artery (Acom) aneurysm development, and moderate evidence for several other markers. No hemodynamic markers yielded converging or moderate evidence. There was large heterogeneity across studies, especially in the definitions of imaging markers and study outcomes used. Due to the poor methodological quality of many studies and unavailability of effect sizes or crude data to calculate effect sizes, a formal meta-analysis was not possible. Many studies had poor methodological quality and varied inmarkerdefinitions and outcome measuresused, which prevented us from performing a formal meta-analysis. CONCLUSIONS We only identified A1 segment asymmetry as an imaging marker of Acom aneurysm development with converging evidence. A meta-analysis was not possible due to the heterogeneity of marker definitions and outcomes used, and poor methodological quality of many studies. Future studies should use robust study designs and uniformly defined imaging markers and outcome measures.
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Affiliation(s)
- Angelina K Kancheva
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, the Netherlands.
| | - Birgitta K Velthuis
- Department of Radiology, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Ynte M Ruigrok
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, the Netherlands
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CircRNA_0079586 and circRNA_RanGAP1 are involved in the pathogenesis of intracranial aneurysms rupture by regulating the expression of MPO. Sci Rep 2021; 11:19800. [PMID: 34611229 PMCID: PMC8492745 DOI: 10.1038/s41598-021-99062-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/30/2021] [Indexed: 11/09/2022] Open
Abstract
Several circRNAs have been reported to be dysregulated in human endothelial cells through sponging miRNAs. Previous reports demonstrated that MPO not only contributed to the formation and rupture of cerebral aneurysm but was also correlated with the degenerative remodeling predisposition to saccular intracranial aneurysm wall rupture, although its underlying mechanisms remain to be explored. Microarray screening was performed to compare the differential expression of circRNAs in the endothelial cells collected from UIAs and RIAs patients. Luciferase assays were used to explore the regulatory relationship between circRNAs and miRNAs, and between miRNAs and their target genes. Microarray screening analysis found a batch of up-regulated circRNAs in the endothelial cells harvested from RIAs patients, including circRNA-0079586 and circRNA-RanGAP1. Luciferase assays revealed the suppressive role of miR-183-5p/miR-877-3p in the expression of circRNA-0079586/circRNA-RanGAP1/MPO. And the expression of circRNA-0079586 and circRNA-RanGAP1 was respectively suppressed by the overexpression of miR-183-5p and miR-877-3p. And both the transfection of miR-183-5p and miR-877-3p mimics suppressed the relative expression level of MPO mRNA. The expression of circRNA-0079586, circRNA-RanGAP1 and MPO was significantly activated in the endothelial cells collected from RIAs patients when compared with UIAs patients, whereas the expression of miR-183-5p and miR-877-3p was remarkably suppressed in the endothelial cells collected from RIAs patients when compared with UIAs patients. We further altered the expression of circRNA-0079586 and circRNA-RanGAP1 using siRNA and overexpression in HUVECS, and the expression of circRNA-0079586 and circRNA-RanGAP1 was significantly and negatively correlated with the expression of miR-183-5p and miR-877-3p, but positively correlated with the expression of MPO under different conditions. In this study, we established two MPO-modulating signaling pathways of circRNA_0079586/miR-183-5p/MPO and circRNA_RanGAP1/miR-877-3p/MPO. These two signaling pathways are involved in the pathogenesis of intracranial aneurysms rupture.
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Gutierrez J, Porras TN, Yoo-Jeong M, Khasiyev F, Igwe KC, Laing KK, Brickman AM, Pavol M, Schnall R. Cerebrovascular Contributions to Neurocognitive Disorders in People Living With HIV. J Acquir Immune Defic Syndr 2021; 88:79-85. [PMID: 34397745 PMCID: PMC8371714 DOI: 10.1097/qai.0000000000002729] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 04/07/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND To investigate a comprehensive array of magnetic resonance imaging (MRI)-based biomarkers of cerebrovascular disease (CVD) in a cohort of people living with HIV (PLWH) and relate these imaging biomarkers to cognition. SETTINGS Cross-sectional, community-based study. METHODS Participants were PLWH in New York City, aged 50 years or older. They underwent a brain magnetic resonance angiography or MRI to ascertain 7 MRI markers of CVD: silent brain infarcts, dilated perivascular spaces, microhemorrhages, white matter hyperintensity volume, white matter fractional anisotropy and mean diffusivity (measures of white matter integrity), and intracranial large artery stenosis. Participants underwent a battery of neurocognitive tests to obtain individual and global cognitive scores representative of various aspects of cognition. RESULTS We included 85 participants (mean age 60 ± 6 years, 48% men, 78% non-Hispanic Black), most of them with well-controlled HIV (75% with CD4 cell count > 200 cells/mm3 and viral load < 400 copies/mL at or near the time of the MRI scan). Silent brain infarcts, intracranial large artery stenosis, and poor white matter integrity were associated with poorer performance in at least one cognitive domain, but the sum of these 3 MRI markers of CVD was associated with lower working memory (B = -0.213, P = 0.028), list learning (B = -0.275, P = 0.019), and global cognition (B = -0.129, P = 0.007). CONCLUSIONS We identified silent brain infarcts, intracranial large artery stenosis, and poor white matter integrity as exposures that may be modifiable and may, therefore, influence cognitive decline. In addition, these MRI markers of CVD may help in identifying PLWH at higher risk of cognitive decline, which may be more amenable to targeted therapies.
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Affiliation(s)
- Jose Gutierrez
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
- Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - Tiffany N Porras
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Moka Yoo-Jeong
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA
| | - Farid Khasiyev
- Department of Neurology, Saint Louis University, Saint Louis, MI
| | - Kay C Igwe
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Krystal K Laing
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Adam M Brickman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
- Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY
| | - Marykay Pavol
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Rebecca Schnall
- School of Nursing, Columbia University Irving Medical Center, New York, NY; and
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
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Zimny M, Kawlewska E, Hebda A, Wolański W, Ładziński P, Kaspera W. Wall shear stress gradient is independently associated with middle cerebral artery aneurysm development: a case-control CFD patient-specific study based on 77 patients. BMC Neurol 2021; 21:281. [PMID: 34281533 PMCID: PMC8287678 DOI: 10.1186/s12883-021-02251-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Abstract
Background Previously published computational fluid dynamics (CFD) studies regarding intracranial aneurysm (IA) formation present conflicting results. Our study analysed the involvement of the combination of high wall shear stress (WSS) and a positive WSS gradient (WSSG) in IA formation. Methods We designed a case-control study with a selection of 38 patients with an unruptured middle cerebral artery (MCA) aneurysm and 39 non-aneurysmal controls to determine the involvement of WSS, oscillatory shear index (OSI), the WSSG and its absolute value (absWSSG) in aneurysm formation based on patient-specific CFD simulations using velocity profiles obtained from transcranial colour-coded sonography. Results Among the analysed parameters, only the WSSG had significantly higher values compared to the controls (11.05 vs − 14.76 [Pa/mm], P = 0.020). The WSS, absWSSG and OSI values were not significantly different between the analysed groups. Logistic regression analysis identified WSS and WSSG as significant co-predictors for MCA aneurysm formation, but only the WSSG turned out to be a significant independent prognosticator (OR: 1.009; 95% CI: 1.001–1.017; P = 0.025). Significantly more patients (23/38) in the case group had haemodynamic regions of high WSS combined with a positive WSSG near the bifurcation apex, while in the control group, high WSS was usually accompanied by a negative WSSG (14/39). From the analysis of the ROC curve for WSSG, the area under the curve (AUC) was 0.654, with the optimal cut-off value −0.37 Pa/mm. The largest AUC was recognised for combined WSS and WSSG (AUC = 0.671). Our data confirmed that aneurysms tend to form near the bifurcation apices in regions of high WSS values accompanied by positive WSSG. Conclusions The development of IAs is determined by an independent effect of haemodynamic factors. High WSS impacts MCA aneurysm formation, while a positive WSSG mainly promotes this process.
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Affiliation(s)
- Mikołaj Zimny
- Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland
| | - Edyta Kawlewska
- Department of Biomechatronics, Silesian University of Technology, Zabrze, Poland
| | - Anna Hebda
- Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Wojciech Wolański
- Department of Biomechatronics, Silesian University of Technology, Zabrze, Poland
| | - Piotr Ładziński
- Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland
| | - Wojciech Kaspera
- Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland.
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Poppenberg KE, Zebraski HR, Avasthi N, Waqas M, Siddiqui AH, Jarvis JN, Tutino VM. Epigenetic landscapes of intracranial aneurysm risk haplotypes implicate enhancer function of endothelial cells and fibroblasts in dysregulated gene expression. BMC Med Genomics 2021; 14:162. [PMID: 34134708 PMCID: PMC8210394 DOI: 10.1186/s12920-021-01007-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Genome-wide association studies have identified many single nucleotide polymorphisms (SNPs) associated with increased risk for intracranial aneurysm (IA). However, how such variants affect gene expression within IA is poorly understood. We used publicly-available ChIP-Seq data to study chromatin landscapes surrounding risk loci to determine whether IA-associated SNPs affect functional elements that regulate gene expression in cell types comprising IA tissue. METHODS We mapped 16 significant IA-associated SNPs to linkage disequilibrium (LD) blocks within human genome. Using ChIP-Seq data, we examined these regions for presence of H3K4me1, H3K27ac, and H3K9ac histone marks (typically associated with latent/active enhancers). This analysis was conducted in several cell types that are present in IA tissue (endothelial cells, smooth muscle cells, fibroblasts, macrophages, monocytes, neutrophils, T cells, B cells, NK cells). In cell types with significant histone enrichment, we used HiC data to investigate topologically associated domains (TADs) encompassing the LD blocks to identify genes that may be affected by IA-associated variants. Bioinformatics were performed to determine the biological significance of these genes. Genes within HiC-defined TADs were also compared to differentially expressed genes from RNA-seq/microarray studies of IA tissues. RESULTS We found that endothelial cells and fibroblasts, rather than smooth muscle or immune cells, have significant enrichment for enhancer marks on IA risk haplotypes (p < 0.05). Bioinformatics demonstrated that genes within TADs subsuming these regions are associated with structural extracellular matrix components and enzymatic activity. The majority of histone marked TADs (83% fibroblasts [IMR90], 77% HUVEC) encompassed at least one differentially expressed gene from IA tissue studies. CONCLUSIONS These findings provide evidence that genetic variants associated with IA risk act on endothelial cells and fibroblasts. There is strong circumstantial evidence that this may be mediated through altered enhancer function, as genes in TADs encompassing enhancer marks have also been shown to be differentially expressed in IA tissue. These genes are largely related to organization and regulation of the extracellular matrix. This study builds upon our previous (Poppenberg et al., BMC Med Genomics, 2019) by including a more diverse set of data from additional cell types and by identifying potential affected genes (i.e. those in TADs).
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Affiliation(s)
- Kerry E Poppenberg
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY, 14214, USA
- Department of Neurosurgery, University at Buffalo, Buffalo, NY, USA
| | - Haley R Zebraski
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY, 14214, USA
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
| | - Naval Avasthi
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY, 14214, USA
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
| | - Muhammad Waqas
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY, 14214, USA
- Department of Neurosurgery, University at Buffalo, Buffalo, NY, USA
| | - Adnan H Siddiqui
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY, 14214, USA
- Department of Neurosurgery, University at Buffalo, Buffalo, NY, USA
| | - James N Jarvis
- Department of Pediatrics, University at Buffalo, Buffalo, NY, USA
| | - Vincent M Tutino
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY, 14214, USA.
- Department of Neurosurgery, University at Buffalo, Buffalo, NY, USA.
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA.
- Department of Pathology and Anatomical Sciences, University at Buffalo, Buffalo, NY, USA.
- Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, USA.
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Bennett P, Aguiar GBD, Silva RCD. The relationship between smoking and brain aneurysms: from formation to rupture. Rev Assoc Med Bras (1992) 2021; 67:895-899. [DOI: 10.1590/1806-9282.20210293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/02/2021] [Indexed: 11/22/2022] Open
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Investigating the Association between Aortic Arch Variants and Intracranial Aneurysms. Can J Neurol Sci 2021; 49:364-367. [PMID: 33988114 DOI: 10.1017/cjn.2021.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is an association between anterior cerebral artery vessel asymmetry and anterior communicating artery aneurysm, presumably based on flow dynamics. The purpose of this study is to investigate the potential relationship between aortic arch branching patterns and incidence of intracranial aneurysm. METHODS This study included patients scanned over 1 year at our tertiary care center who underwent high-resolution imaging (computed tomography angiography or digital subtracted angiogram) of the head and neck arteries, aortic arch, and superior mediastinum. Exclusion criteria included patients with suboptimal images. Patient age, gender, aortic arch branching pattern, and the presence, location, and number of aneurysms were documented. RESULTS Among the 1082 patients analyzed, 250 (23%) patients had a variant aortic arch branching pattern, 22 (8.8%) of whom had aneurysms. There were 104 patients with 126 aneurysms, with majority of patients with normal aortic arch branching pattern (n = 82, 79%). The most common variant was a common origin of the left common carotid artery and brachiocephalic trunk with or without direct origin of the left vertebral artery. Twenty-two patients with aneurysms had an aberrant aortic arch (21%), compared to 232 patients without an aneurysm (24%). Fischer exact test showed no statistically significant difference between the incidence of aneurysm with different aortic arch variant groups (two-tailed p-value = 0.715). CONCLUSION To our knowledge, this is the first study to examine the association between aortic arch branching patterns and incidence of intracranial aneurysm. No significant association was found between aortic arch branching pattern and the incidence of intracranial aneurysm.
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Pozzi S, Domanin M, Forzenigo L, Votta E, Zunino P, Redaelli A, Vergara C. A surrogate model for plaque modeling in carotids based on Robin conditions calibrated by cine MRI data. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3447. [PMID: 33586336 DOI: 10.1002/cnm.3447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
We propose a surrogate model for the fluid-structure interaction (FSI) problem for the study of blood dynamics in carotid arteries in presence of plaque. This is based on the integration of a numerical model with subject-specific data and clinical imaging. We propose to model the plaque as part of the tissues surrounding the vessel wall through the application of an elastic support boundary condition. In order to characterize the plaque and other surrounding tissues, such as the close-by jugular vein, the elastic parameters of the boundary condition were spatially differentiated and their values were estimated by minimizing the discrepancies between computed vessel displacements and reference values obtained from CINE Magnetic Resonance Imaging data. We applied the model to three subjects with a degree of stenosis greater than 70%. We found that accounting for both plaque and jugular vein in the estimation of the elastic parameters increases the accuracy. In particular, in all patients, mismatches between computed and in vivo measured wall displacements were one to two orders of magnitude lower than the spatial resolution of the original MRI data. These results confirmed the validity of the proposed surrogate plaque model. We also compared fluid-dynamics results with those obtained in a fixed wall setting and in a full FSI model, used as gold standard, highlighting the better accordance of our results in comparison to the rigid ones.
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Affiliation(s)
- Silvia Pozzi
- MOX, Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - Maurizio Domanin
- Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy
- Unità Operativa di Chirurgia Vascolare, Fondazione I.R.C.C.S. Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Forzenigo
- Unità Operativa di Radiologia, Fondazione I.R.C.C.S. Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Emiliano Votta
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Paolo Zunino
- MOX, Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - Alberto Redaelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Christian Vergara
- LaBS, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", Politecnico di Milano, Milan, Italy
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Shahjouei S, Ghodsi SM, Zangeneh Soroush M, Ansari S, Kamali-Ardakani S. Artificial Neural Network for Predicting the Safe Temporary Artery Occlusion Time in Intracranial Aneurysmal Surgery. J Clin Med 2021; 10:1464. [PMID: 33918168 PMCID: PMC8037800 DOI: 10.3390/jcm10071464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/16/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Temporary artery clipping facilitates safe cerebral aneurysm management, besides a risk for cerebral ischemia. We developed an artificial neural network (ANN) to predict the safe clipping time of temporary artery occlusion (TAO) during intracranial aneurysm surgery. METHOD We devised a three-layer model to predict the safe clipping time for TAO. We considered age, the diameter of the right and left middle cerebral arteries (MCAs), the diameter of the right and left A1 segment of anterior cerebral arteries (ACAs), the diameter of the anterior communicating artery, mean velocity of flow at the right and left MCAs, and the mean velocity of flow at the right and left ACAs, as well as the Fisher grading scale of brain CT scans as the input values for the model. RESULTS This study included 125 patients: 105 patients from a retrospective cohort for training the model and 20 patients from a prospective cohort for validating the model. The output of the neural network yielded up to 960 s overall safe clipping time for TAO. The input values with the greatest impact on safe TAO were mean velocity of blood at left MCA and left ACA, and Fisher grading scale of brain CT scan. CONCLUSION This study presents an axillary framework to improve the accuracy of the estimated safe clipping time interval of temporary artery occlusion in intracranial aneurysm surgery.
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Affiliation(s)
- Shima Shahjouei
- Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA
- Department of Neurosurgery, Tehran University of Medical Sciences, Tehran 14155-6559, Iran; (S.M.G.); (S.K.-A.)
| | - Seyed Mohammad Ghodsi
- Department of Neurosurgery, Tehran University of Medical Sciences, Tehran 14155-6559, Iran; (S.M.G.); (S.K.-A.)
| | - Morteza Zangeneh Soroush
- Bio-Intelligence Research Unit, Electrical Engeneering Department, Sharif University of Technology, Tehran 14588-89694, Iran;
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran 14778-93855, Iran
| | - Saeed Ansari
- National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD 20892, USA;
| | - Shahab Kamali-Ardakani
- Department of Neurosurgery, Tehran University of Medical Sciences, Tehran 14155-6559, Iran; (S.M.G.); (S.K.-A.)
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Cai S, Li H, Zheng F, Kong F, Dao M, Karniadakis GE, Suresh S. Artificial intelligence velocimetry and microaneurysm-on-a-chip for three-dimensional analysis of blood flow in physiology and disease. Proc Natl Acad Sci U S A 2021; 118:e2100697118. [PMID: 33762307 PMCID: PMC8020788 DOI: 10.1073/pnas.2100697118] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Understanding the mechanics of blood flow is necessary for developing insights into mechanisms of physiology and vascular diseases in microcirculation. Given the limitations of technologies available for assessing in vivo flow fields, in vitro methods based on traditional microfluidic platforms have been developed to mimic physiological conditions. However, existing methods lack the capability to provide accurate assessment of these flow fields, particularly in vessels with complex geometries. Conventional approaches to quantify flow fields rely either on analyzing only visual images or on enforcing underlying physics without considering visualization data, which could compromise accuracy of predictions. Here, we present artificial-intelligence velocimetry (AIV) to quantify velocity and stress fields of blood flow by integrating the imaging data with underlying physics using physics-informed neural networks. We demonstrate the capability of AIV by quantifying hemodynamics in microchannels designed to mimic saccular-shaped microaneurysms (microaneurysm-on-a-chip, or MAOAC), which signify common manifestations of diabetic retinopathy, a leading cause of vision loss from blood-vessel damage in the retina in diabetic patients. We show that AIV can, without any a priori knowledge of the inlet and outlet boundary conditions, infer the two-dimensional (2D) flow fields from a sequence of 2D images of blood flow in MAOAC, but also can infer three-dimensional (3D) flow fields using only 2D images, thanks to the encoded physics laws. AIV provides a unique paradigm that seamlessly integrates images, experimental data, and underlying physics using neural networks to automatically analyze experimental data and infer key hemodynamic indicators that assess vascular injury.
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Affiliation(s)
- Shengze Cai
- Division of Applied Mathematics, Brown University, Providence, RI 02912
| | - He Li
- Division of Applied Mathematics, Brown University, Providence, RI 02912
| | - Fuyin Zheng
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
- School of Biological Sciences, Nanyang Technological University, 639798 Singapore
| | - Fang Kong
- School of Biological Sciences, Nanyang Technological University, 639798 Singapore
| | - Ming Dao
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139;
| | - George Em Karniadakis
- Division of Applied Mathematics, Brown University, Providence, RI 02912;
- School of Engineering, Brown University, Providence, RI 02912
| | - Subra Suresh
- Nanyang Technological University, 639798 Singapore
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Żyłkowski J, Rosiak G, Rowiński O, Spińczyk D. Age- and gender-dependent variability in the geometry of middle cerebral artery bifurcations. J Anat 2021; 238:765-784. [PMID: 33107033 PMCID: PMC7855074 DOI: 10.1111/joa.13338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 11/27/2022] Open
Abstract
The goal of this study was to analyze trends in the geometric parameters of blood vessels with age in a randomly selected group of 200 computed tomography angiography studies of radiologically healthy individuals using dedicated statistical techniques. A quantitative description of cerebral vascular geometry with numerical parameters (bifurcation angle, branching angle, co-planarity index, average curvature, and average torsion) was proposed. The changes and variability in geometry were analyzed according to age. The bifurcation angle, branching angle, and average curvature increased with age, whereas the co-planarity index and average torsion decreased with age. For equal-diameter branches, women comparing to men presented lower bifurcation angles in the 4th decade of life, and lower values for the co-planarity index in the 3rd and 4th decades of life. In non-equal-diameter branches, the opposite relationship was observed for bifurcation angle in the 4th decade of life comparing both groups. All analyzed parameters showed clearly visible trends with patient age. Deviations in specific decades of life were detected; these deviations could be linked to the development of aneurysms in specific age groups.
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Affiliation(s)
| | - Grzegorz Rosiak
- II Department of RadiologyMedical University of WarsawWarsawPoland
| | - Olgierd Rowiński
- II Department of RadiologyMedical University of WarsawWarsawPoland
| | - Dominik Spińczyk
- Faculty of Biomedical EngineeringSilesian University of TechnologyZabrzePoland
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Sabotin RP, Varon A, Roa JA, Raghuram A, Ishii D, Nino M, Galloy AE, Patel D, Raghavan ML, Hasan D, Samaniego EA. Insights into the pathogenesis of cerebral fusiform aneurysms: high-resolution MRI and computational analysis. J Neurointerv Surg 2021; 13:1180-1186. [PMID: 33632878 DOI: 10.1136/neurintsurg-2020-017243] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Intracranial fusiform aneurysms are complex and poorly characterized vascular lesions. High-resolution magnetic resonance imaging (HR-MRI) and computational morphological analysis may be used to characterize cerebral fusiform aneurysms. OBJECTIVE To use advanced imaging and computational analysis to understand the unique pathophysiology, and determine possible underlying mechanisms of instability of cerebral fusiform aneurysms. METHODS Patients with unruptured intracranial aneurysms prospectively underwent imaging with 3T HR-MRI at diagnosis. Aneurysmal wall enhancement was objectively quantified using signal intensity after normalization of the contrast ratio (CR) with the pituitary stalk. Enhancement between saccular and fusiform aneurysms was compared, as well as enhancement characteristics of fusiform aneurysms. The presence of microhemorrhages in fusiform aneurysms was determined with quantitative susceptibility mapping (QSM). Three distinct types of fusiform aneurysms were analyzed with computational fluid dynamics (CFD) and finite element analysis (FEA). RESULTS A total of 130 patients with 160 aneurysms underwent HR-MRI. 136 aneurysms were saccular and 24 were fusiform. Fusiform aneurysms had a significantly higher CR and diameter than saccular aneurysms. Enhancing fusiform aneurysms exhibited more enhancement of reference vessels than non-enhancing fusiform aneurysms. Ten fusiform aneurysms underwent QSM analysis, and five aneurysms showed microhemorrhages. Microhemorrhage-positive aneurysms had a larger volume, diameter, and greater enhancement than aneurysms without microhemorrhage. Three types of fusiform aneurysms exhibited different CFD and FEA patterns. CONCLUSION Fusiform aneurysms exhibited more contrast enhancement than saccular aneurysms. Enhancing fusiform aneurysms had larger volume and diameter, more enhancement of reference vessels, and more often exhibited microhemorrhage than non-enhancing aneurysms. CFD and FEA suggest that various pathophysiological processes determine the formation and growth of fusiform aneurysms.
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Affiliation(s)
- Ryan Phillip Sabotin
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Alberto Varon
- Department of Neurology, The University of Iowa, Iowa City, Iowa, USA
| | - Jorge A Roa
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Ashrita Raghuram
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Daizo Ishii
- Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Marco Nino
- Roy J Carver Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Adam E Galloy
- Roy J Carver Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Devanshee Patel
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Madhavan L Raghavan
- Roy J Carver Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - David Hasan
- Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Edgar A Samaniego
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA .,Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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45
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Hosseini V, Mallone A, Nasrollahi F, Ostrovidov S, Nasiri R, Mahmoodi M, Haghniaz R, Baidya A, Salek MM, Darabi MA, Orive G, Shamloo A, Dokmeci MR, Ahadian S, Khademhosseini A. Healthy and diseased in vitro models of vascular systems. LAB ON A CHIP 2021; 21:641-659. [PMID: 33507199 DOI: 10.1039/d0lc00464b] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Irregular hemodynamics affects the progression of various vascular diseases, such atherosclerosis or aneurysms. Despite the extensive hemodynamics studies on animal models, the inter-species differences between humans and animals hamper the translation of such findings. Recent advances in vascular tissue engineering and the suitability of in vitro models for interim analysis have increased the use of in vitro human vascular tissue models. Although the effect of flow on endothelial cell (EC) pathophysiology and EC-flow interactions have been vastly studied in two-dimensional systems, they cannot be used to understand the effect of other micro- and macro-environmental parameters associated with vessel wall diseases. To generate an ideal in vitro model of the vascular system, essential criteria should be included: 1) the presence of smooth muscle cells or perivascular cells underneath an EC monolayer, 2) an elastic mechanical response of tissue to pulsatile flow pressure, 3) flow conditions that accurately mimic the hemodynamics of diseases, and 4) geometrical features required for pathophysiological flow. In this paper, we review currently available in vitro models that include flow dynamics and discuss studies that have tried to address the criteria mentioned above. Finally, we critically review in vitro fluidic models of atherosclerosis, aneurysm, and thrombosis.
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Affiliation(s)
- Vahid Hosseini
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
| | - Anna Mallone
- Institute of Regenerative Medicine, University of Zurich, Zurich CH-8952, Switzerland
| | - Fatemeh Nasrollahi
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
| | - Serge Ostrovidov
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and Department of Radiological Sciences, University of California-Los Angeles, CA 90095, USA
| | - Rohollah Nasiri
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Department of Mechanical Engineering, Sharif University of Technology, Tehran 1136511155, Iran
| | - Mahboobeh Mahmoodi
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Department of Biomedical Engineering, Yazd Branch, Islamic Azad University, Yazd 8915813135, Iran
| | - Reihaneh Haghniaz
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
| | - Avijit Baidya
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA
| | - M Mehdi Salek
- School of Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Mohammad Ali Darabi
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
| | - Gorka Orive
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz 01006, Spain and Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz 01007, Spain
| | - Amir Shamloo
- Department of Mechanical Engineering, Sharif University of Technology, Tehran 1136511155, Iran
| | - Mehmet R Dokmeci
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
| | - Samad Ahadian
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
| | - Ali Khademhosseini
- Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, CA 90095, USA and California NanoSystems Institute and Department of Bioengineering, University of California-Los Angeles, CA 90095, USA and Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
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46
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Mahrous SA, Sidik NAC, Saqr KM. Numerical study on the energy cascade of pulsatile Newtonian and power-law flow models in an ICA bifurcation. PLoS One 2021; 16:e0245775. [PMID: 33493237 PMCID: PMC7833255 DOI: 10.1371/journal.pone.0245775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022] Open
Abstract
The complex physics and biology underlying intracranial hemodynamics are yet to be fully revealed. A fully resolved direct numerical simulation (DNS) study has been performed to identify the intrinsic flow dynamics in an idealized carotid bifurcation model. To shed the light on the significance of considering blood shear-thinning properties, the power-law model is compared to the commonly used Newtonian viscosity hypothesis. We scrutinize the kinetic energy cascade (KEC) rates in the Fourier domain and the vortex structure of both fluid models and examine the impact of the power-law viscosity model. The flow intrinsically contains coherent structures which has frequencies corresponding to the boundary frequency, which could be associated with the regulation of endothelial cells. From the proposed comparative study, it is found that KEC rates and the vortex-identification are significantly influenced by the shear-thinning blood properties. Conclusively, from the obtained results, it is found that neglecting the non-Newtonian behavior could lead to underestimation of the hemodynamic parameters at low Reynolds number and overestimation of the hemodynamic parameters by increasing the Reynolds number. In addition, we provide physical insight and discussion onto the hemodynamics associated with endothelial dysfunction which plays significant role in the pathogenesis of intracranial aneurysms.
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Affiliation(s)
- Samar A. Mahrous
- Department of Thermo-Fluid Universiti Teknologi Malaysia, Skudai, Malaysia
- College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria, Egypt
- * E-mail:
| | - Nor Azwadi Che Sidik
- Department of Thermo-Fluid Universiti Teknologi Malaysia, Skudai, Malaysia
- Malaysia–Japan International Institute of Technology (MJIIT), University Teknologi Malaysia Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Khalid M. Saqr
- College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria, Egypt
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Li J, Zheng L, Yang WJ, Sze-To CY, Leung TWH, Chen XY. Plaque Wall Distribution Pattern of the Atherosclerotic Middle Cerebral Artery Associates With the Circle of Willis Completeness. Front Neurol 2021; 11:599459. [PMID: 33505347 PMCID: PMC7829315 DOI: 10.3389/fneur.2020.599459] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Investigating the relevance of the incomplete circle of Willis (COW) to the plaque wall distribution in the atherosclerotic middle cerebral arteries (MCAs) through utilizing high-resolution magnetic resonance imaging (HR-MRI), and its potential clinical impact. Methods: This hospital-based study enrolled consecutive adult patients with acute ischemic stroke or transient ischemic attack, who received a 3.0T Achieva MR system scanning. The COW completeness was evaluated on MR angiography imaging, including anterior (A) and posterior (P)-COW sections. The MCA plaque wall distribution was assessed on HR-MRI. The occurrence of perforator infarction was detected on diffusion-weighted imaging. Results: Among 87 patients (mean age = 62.39 ± 11.64 years old) with atherosclerotic plaques in the MCA M1 segments, the incomplete COW types were more prevalent than the complete COW type (incomplete P-COW, 83.9%; incomplete A-COW, 36.8%; complete COW, 8.1%). The incomplete A-COW had more inferior but fewer ventral plaques of MCA atherosclerosis than the complete A-COW, while the incomplete P-COW had fewer inferior MCA plaques than the complete P-COW. Moreover, symptomatic MCA plaques causing perforator infarctions were more likely to locate on the superior wall. Conclusion: Our findings suggested that the COW completeness could influence the vessel wall distribution of the MCA plaques, among which the superior plaques of symptomatic MCA atherosclerosis was associated with branch occlusive disease.
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Affiliation(s)
- Jia Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Lu Zheng
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wen-Jie Yang
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, United States
| | - Cheuk-Yin Sze-To
- Department of Diagnostic and Interventional Radiology, The Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong
| | - Thomas Wai-Hong Leung
- Division of Neurology, Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Xiang-Yan Chen
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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48
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Kannojiya V, Das AK, Das PK. Simulation of Blood as Fluid: A Review From Rheological Aspects. IEEE Rev Biomed Eng 2021; 14:327-341. [DOI: 10.1109/rbme.2020.3011182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Brunasso L, Alotta G, Zingales M, Iacopino DG, Graziano F. Can biomechanical analysis shed some light on aneurysmal pathophysiology? Preliminary study on ex vivo cerebral arterial walls. Clin Biomech (Bristol, Avon) 2021; 81:105184. [PMID: 33309932 DOI: 10.1016/j.clinbiomech.2020.105184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/06/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The pathophysiology of cerebral aneurysm is complex and poorly understood, and it can have the most catastrophic clinical presentation. Flow dynamics is a key player in the initiation and progression of aneurysm. Better understanding the interaction between hemodynamic loading and biomechanical wall responses can help to add the missing piece on aneurysmal pathophysiology. In this laboratory study we aimed to analyze the effect of the application of a mechanical force to cerebral arterial walls. METHODS Displacement control tests were performed on five porcine cerebral arteries. The test machine was the T150 Nanotensile. The stiffness variation with the increment of the strain level is modeled as the outcome of an isotropic hyperelastic material model. FINDINGS Through the application of an axial force we obtained Stress/Strain curves that showed a marked isotropic hyperelastic behavior, characterized by an increasing of stiffness with the level of strain. This behavior of the cerebral arterial wall is different from the well-established behavior of other arterial vessel (as the aortic vessel) characterized by a marked anisotropic behavior. Additionally, the data scattering observed for higher values of the applied stress are related to different individual packing of collagen fibers that represent the load-bearing mechanics at higher level of the strain. INTERPRETATION The data obtained by test in this paper represent a first step in our ongoing research about the mechanics of multi-axial loads on cerebral arterial walls, and in producing more comprehensive patient-specific calculations for potential applications on cerebral aneurysm management.
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Affiliation(s)
- L Brunasso
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone", 90100 Palermo, Italy
| | - G Alotta
- Dipartimento di Ingegneria Civile, dell'Energia, dell'Ambiente, e dei Material, Università degli Studi "Mediterranea" di Reggio Calabria, Via Graziella-Vito, 89122 Reggio Calabria, RC, Italy
| | - M Zingales
- Bio/NanoMechanics for Medical Sciences Laboratory, ATeN-Center, Università degli Studi di Palermo, Viale delle Scienze ed.18, Palermo, Italy; Dipartimento di Ingegneria, Viale delle Scienze, Università degli Studi di Palermo,ed.8, 90128 Palermo, Italy.
| | - D G Iacopino
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone", 90100 Palermo, Italy
| | - F Graziano
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone", 90100 Palermo, Italy; Azienda ospedaliera di Rilievo Nazionale e di Alta Specializzazione (ARNAS), "G. Garibaldi", Piazza S. Maria di Gesù n.5, 95124 Catania, Italy
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50
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A review of hemodynamic parameters in cerebral aneurysm. INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT 2020. [DOI: 10.1016/j.inat.2020.100716] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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