Object: The difference in the hemodynamics of wall shear stress (WSS) and oscillatory shear index (OSI) between ruptured and unruptured aneurysms is not well understood. The authors investigated the hemodynamic similarities and dissimilarities in ruptured and thin-walled unruptured aneurysm blebs.
Methods: Magnetic resonance imaging-based fluid dynamics analysis was used to calculate WSS and OSI, and hemodynamic and intraoperative findings were compared. The authors also compared ruptured and unruptured thin-walled blebs for the magnitude of WSS and OSI.
Results: Intraoperatively, 13 ruptured and 139 thin-walled unruptured aneurysm blebs were identified. Twelve of the ruptured (92.3%) and 124 of the unruptured blebs (89.2%) manifested low WSS and high OSI. The degree of WSS was significantly lower in ruptured (0.49 ± 0.12 Pa) than in unruptured (0.64 ± 0.15 Pa; p < 0.01) blebs.
Conclusions: Ruptured and unruptured blebs shared a distinctive pattern of low WSS and high OSI. The degree of WSS at the rupture site was significantly lower than in the unruptured thin-walled blebs.
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http://dx.doi.org/10.3171/2012.7.JNS111991 | DOI Listing |
Interv Neuroradiol
December 2024
Department of Neurosurgery, Clinical Neuroscience Center, University of Utah, Salt Lake City, UT, USA.
Background: The integration of robotics into neuroendovascular surgery has the potential to revolutionize the field by enhancing precision, reducing procedure-related risks, and improving patient outcomes. The CorPath GRX system represents a significant advancement in this domain. In this systematically conducted scoping review, we explore the current applications, advances, and challenges associated with robot-assisted neuroendovascular surgery.
View Article and Find Full Text PDFNeuroscience
December 2024
Department of Neurosurgery, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China. Electronic address:
The aim of this study was to assess the potential causal relationship between lifestyle factors and intracranial aneurysms (IAs) using a two-sample Mendelian randomization (MR) approach. The study used a pooled dataset from a genome-wide association study that covered information on 24 lifestyle factors, intracranial aneurysm cases, subarachnoid hemorrhage, and unruptured aneurysms. Five MR methods were applied for analysis by selecting single nucleotide polymorphisms as instrumental variables, with the inverse variance weighting method as the main method.
View Article and Find Full Text PDFJ Neurosurg
December 2024
Departments of1Neurological Surgery.
Objective: Endovascular intracranial aneurysm (IA) management has significantly evolved over the last 2 decades. Despite these advancements, the aneurysm recanalization rate after coil embolization remains a concern. Statins have been found to affect vascular repair and remodeling; therefore, the authors hypothesized that patients receiving statin therapy at the time of coil embolization would have lower aneurysm recurrence and retreatment rates compared with patients not receiving statin therapy.
View Article and Find Full Text PDFQuant Imaging Med Surg
December 2024
Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Background: The hemodynamics of cerebral arteriovenous malformation (cAVM) is difficult to evaluate with conventional imaging or clinical grading. The aim of this study is to: (I) investigate the association between the angioarchitecture and hemodynamic parameters in cAVM based on 4-dimentional flow magnetic resonance (4D flow MR); (II) quantify flow changes during follow-up after embolization and explore the potential of flow-guided staged embolization.
Methods: Twenty-one patients with digital subtraction angiography (DSA)-diagnosed cAVM were prospectively enrolled in a tertiary hospital consecutively from April 2022 to January 2024 for a cohort study.
Neurosurg Rev
December 2024
Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA.
Recent advancements in endovascular treatment (EVT) and different views on optimal management for posterior communicating artery (PComA) aneurysms with oculomotor nerve palsy (ONP) highlight a need to compare recovery timelines between microsurgery and EVT; heterogeneous outcomes and influencing factors may also affect results. A comprehensive systematic review and meta-analysis were conducted by searching PubMed, Embase, Scopus, and Web of Science databases. The extracted data encompassed patient demographics, details on treatment modalities and timing, and characteristics of PComA aneurysms ONP caused by either unruptured or ruptured aneurysms.
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