Daniel Ribeiro de Sousa1, Carolina Vallecilla2, Kamil Chodzynski3, Ricardo Corredor Jerez2, Orestis Malaspinas4, Omer Faruk Eker5, Rafik Ouared4, Luc Vanhamme6, Alexandre Legrand7, Bastien Chopard4, Guy Courbebaisse2, Karim Zouaoui Boudjeltia3. 1. Laboratory of Experimental Medicine (ULB 222 Unit), CHU de Charleroi-A Vesale Hospital, Université Libre de Bruxelles, Montigny-le-Tilleul, Belgium Department of Pharmacy and Physiology, University of Mons, Mons, Belgium. 2. CREATIS, CNRS UMR 5220, INSERM U1044, UCB Lyon1, INSA Lyon, University of Lyon, Lyon, France. 3. Laboratory of Experimental Medicine (ULB 222 Unit), CHU de Charleroi-A Vesale Hospital, Université Libre de Bruxelles, Montigny-le-Tilleul, Belgium. 4. Department of Computer Sciences, University of Geneva, Geneva, Switzerland. 5. Department of Neuroradiology, University Hospital Center of Montpellier, Montpellier, France. 6. Institute of Molecular Biology and Medicine, Université Libre de Bruxelles, Gosselies, Belgium. 7. Department of Pharmacy and Physiology, University of Mons, Mons, Belgium.
Abstract
BACKGROUND: Particular intra-aneurysmal blood flow conditions, created naturally by the growth of an aneurysm or induced artificially by implantation of a flow diverter stent (FDS), can potentiate intra-aneurysmal thrombosis. The aim of this study was to identify hemodynamic indicators, relevant to this process, which could be used as a prediction of the success of a preventive endovascular treatment. METHOD: A cross sectional study on 21 patients was carried out to investigate the possible association between intra-aneurysmal spontaneous thrombus volume and the dome to neck aspect ratio (AR) of the aneurysm. The mechanistic link between these two parameters was further investigated through a Fourier analysis of the intra-aneurysmal shear rate (SR) obtained by computational fluid dynamics (CFD). This analysis was first applied to 10 additional patients (4 with and 6 without spontaneous thrombosis) and later to 3 patients whose intracranial aneurysms only thrombosed after FDS implantation. RESULTS: The cross sectional study revealed an association between intra-aneurysmal spontaneous thrombus volume and the AR of the aneurysm (R(2)=0.67, p<0.001). Fourier analysis revealed that in cases where thrombosis occurred, the SR harmonics 0, 1, and 2 were always less than 25/s, 10/s, and 5/s, respectively, and always greater than these values where spontaneous thrombosis was not observed. CONCLUSIONS: Our study suggests the existence of an SR threshold below which thrombosis will occur. Therefore, by analyzing the SR on patient specific data with CFD techniques, it may be potentially possible to predict whether or the intra-aneurysmal flow conditions, after FDS implantation, will become prothrombotic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: Particular intra-aneurysmal blood flow conditions, created naturally by the growth of an aneurysm or induced artificially by implantation of a flow diverter stent (FDS), can potentiate intra-aneurysmal thrombosis. The aim of this study was to identify hemodynamic indicators, relevant to this process, which could be used as a prediction of the success of a preventive endovascular treatment. METHOD: A cross sectional study on 21 patients was carried out to investigate the possible association between intra-aneurysmal spontaneous thrombus volume and the dome to neck aspect ratio (AR) of the aneurysm. The mechanistic link between these two parameters was further investigated through a Fourier analysis of the intra-aneurysmal shear rate (SR) obtained by computational fluid dynamics (CFD). This analysis was first applied to 10 additional patients (4 with and 6 without spontaneous thrombosis) and later to 3 patients whose intracranial aneurysms only thrombosed after FDS implantation. RESULTS: The cross sectional study revealed an association between intra-aneurysmal spontaneous thrombus volume and the AR of the aneurysm (R(2)=0.67, p<0.001). Fourier analysis revealed that in cases where thrombosis occurred, the SR harmonics 0, 1, and 2 were always less than 25/s, 10/s, and 5/s, respectively, and always greater than these values where spontaneous thrombosis was not observed. CONCLUSIONS: Our study suggests the existence of an SR threshold below which thrombosis will occur. Therefore, by analyzing the SR on patient specific data with CFD techniques, it may be potentially possible to predict whether or the intra-aneurysmal flow conditions, after FDS implantation, will become prothrombotic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Bastien Chopard; Daniel Ribeiro de Sousa; Jonas Lätt; Lampros Mountrakis; Frank Dubois; Catherine Yourassowsky; Pierre Van Antwerpen; Omer Eker; Luc Vanhamme; David Perez-Morga; Guy Courbebaisse; Eric Lorenz; Alfons G Hoekstra; Karim Zouaoui Boudjeltia Journal: R Soc Open Sci Date: 2017-04-12 Impact factor: 2.963
Authors: Giulio Musotto; Alessandra Monteleone; Danila Vella; Sofia Di Leonardo; Alessia Viola; Giuseppe Pitarresi; Bernardo Zuccarello; Antonio Pantano; Andrew Cook; Giorgia M Bosi; Gaetano Burriesci Journal: Front Cardiovasc Med Date: 2022-07-14