Low wall shear stress is associated with the rupture of intracranial aneurysm with known rupture point: case report and literature review

Hemodynamic insult has long been speculated to be a key factor in intracranial aneurysm (IA) formation,1 but the specifics of hemodynamic insult contributing to this process are not understood. Despite other risk factors, IAs are predominantly found at locations associated with unique hemodynamic stress such as at the apices of arterial bifurcations or outer curves, prominent in high wall shear stress (WSS) and wall shear stress gradients (WSSG).2 Furthermore, it appears that increased flow at these locations is required to trigger the initiation of aneurysmal remodeling.3 We have previously shown that increasing flow in the rabbit basilar artery (BA), secondary to common carotid artery (CCA) ligation, resulted in nascent aneurysm development at the basilar terminus (BT).4 However, it is unclear if certain hemodynamic stress thresholds must be exceeded to trigger aneurysmal remodeling, and whether sustained insult is necessary.

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Effects of smoking and hypertension on wall shear stress and oscillatory shear index at the site of intracranial aneurysm formation

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2009.12.018 ◽

2010 ◽

Vol 112 (4) ◽

pp. 306-313 ◽

Cited By ~ 37

Author(s):

Pankaj K. Singh ◽

Alberto Marzo ◽

Bethany Howard ◽

Daniel A. Rufenacht ◽

Philippe Bijlenga ◽

...

Keyword(s):

Shear Stress ◽

Wall Shear Stress ◽

Intracranial Aneurysm ◽

Oscillatory Shear ◽

Oscillatory Shear Index ◽

Aneurysm Formation ◽

Wall Shear

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Real-World Variability in the Prediction of Intracranial Aneurysm Wall Shear Stress: The 2015 International Aneurysm CFD Challenge

Cardiovascular Engineering and Technology ◽

10.1007/s13239-018-00374-2 ◽

2018 ◽

Vol 9 (4) ◽

pp. 544-564 ◽

Cited By ~ 24

Author(s):

Kristian Valen-Sendstad ◽

Aslak W. Bergersen ◽

Yuji Shimogonya ◽

Leonid Goubergrits ◽

Jan Bruening ◽

...

Keyword(s):

Shear Stress ◽

Wall Shear Stress ◽

Intracranial Aneurysm ◽

Real World ◽

Aneurysm Wall ◽

Wall Shear

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Propose a Wall Shear Stress Divergence to Estimate the Risks of Intracranial Aneurysm Rupture

The Scientific World JOURNAL ◽

10.1155/2013/508131 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Y. Zhang ◽

H. Takao ◽

Y. Murayama ◽

Y. Qian

Keyword(s):

Shear Stress ◽

Wall Shear Stress ◽

Intracranial Aneurysm ◽

Risk Estimation ◽

Aneurysm Rupture ◽

Patient Specific ◽

Luminal Surface ◽

Risk Of Rupture ◽

Computational Fluid Dynamics Cfd ◽

Wall Shear

Although wall shear stress (WSS) has long been considered a critical indicator of intracranial aneurysm rupture, there is still no definite conclusion as to whether a high or a low WSS results in aneurysm rupture. The reason may be that the effect of WSS direction has not been fully considered. The objectives of this study are to investigate the magnitude of WSS (WSS) and its divergence on the aneurysm surface and to test the significance of both in relation to the aneurysm rupture. Patient-specific computational fluid dynamics (CFD) was used to compute WSS and wall shear stress divergence (WSSD) on the aneurysm surface for nineteen patients. Our results revealed that if highWSSis stretching aneurysm luminal surface, and the stretching region is concentrated, the aneurysm is under a high risk of rupture. It seems that, by considering both direction and magnitude of WSS, WSSD may be a better indicator for the risk estimation of aneurysm rupture (154).

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