• Lijian Xu, Hao Wang, Yongchun Chen, Yuchen Dai, Boli Lin, Fuyou Liang, Jieqing Wan, Yunjun Yang, and Bing Zhao.
• School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai, China.
• World Neurosurg. 2020 May 1; 137: e138-e143.

BackgroundMirror intracranial aneurysms with different rupture status is a useful model to investigate features associated with aneurysm rupture. Morphological and hemodynamic analyses of ruptured middle cerebral artery (MCA) mirror aneurysms are rarely reported. The purpose of this study was to determine the morphological or hemodynamic characteristics associated with ruptured MCA mirror aneurysms.MethodsWe performed a retrospective analysis of consecutive 317 patients with MCA aneurysms. Ruptured MCA mirror aneurysms (1 ruptured and mirror unruptured aneurysm) were included. In the matched pairs of ruptured and unruptured mirror aneurysms, 13 morphological parameters were measured using 3-dimensional computed tomography angiography and 6 hemodynamic parameters were evaluated using high-resolution computational fluid dynamic simulations. The association of morphological and hemodynamic characteristics with the rupture of MCA mirror aneurysms was determined.ResultsA total of 20 (6.31%) patients with 40 MCA mirror aneurysms were included in this study. There were significant differences in morphological and hemodynamic parameters between the ruptured and unruptured mirror aneurysms. Irregular aneurysms were 3 times more common in the ruptured aneurysms than in the unruptured aneurysms. A larger aneurysm (P = 0.025), a higher aneurysm (P = 0.020), a larger size ratio (P = 0.009), a higher bottleneck ratio (P = 0.033), an irregular aneurysm (P = 0.022), a higher maximum intra-aneurysmal wall shear stress (WSS; P = 0.020), and a lower normalized average WSS (P = 0.008) were associated with MCA mirror aneurysm rupture.ConclusionsLarger aneurysms, a larger size ratio, irregular aneurysms, a lower spatial average WSS, and a higher maximum WSS may contribute to evaluating the risk of rupture of MCA aneurysms independent of patient characteristics.Copyright © 2020 Elsevier Inc. All rights reserved.

29 keywords...

hide…