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Related Concept Videos

Aneurysm I: Introduction01:30

Aneurysm I: Introduction

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aneurysm III: Interprofessional Care01:26

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Comprehensive morphomechanical analysis of brain aneurysms.

Ashrita Raghuram1, Adam Galloy2, Marco Nino2

  • 1Department of Neurology, University of Iowa, Iowa City, IA, USA.

Acta Neurochirurgica
|January 3, 2023
PubMed
Summary

Multimodal analysis reveals distinct biomechanical environments within brain aneurysms. High aneurysm wall enhancement areas, particularly in blebs, show low wall tension and shear stress, unlike the aneurysm neck.

Keywords:
3DAneurysmCFDFEAMultimodalWall enhancement

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Area of Science:

  • Neuroimaging
  • Biomedical Engineering
  • Cerebrovascular Diseases

Background:

  • Brain aneurysms exhibit complex compartmentalized biology.
  • Understanding aneurysm wall behavior is crucial for predicting rupture risk.

Purpose of the Study:

  • To perform a multimodal analysis of brain aneurysm wall biology.
  • To investigate the relationship between aneurysm wall enhancement (AWE) and biomechanical parameters.

Main Methods:

  • High-resolution MRI (HR-MRI) was used to image 26 unruptured aneurysms.
  • 3D AWE maps were co-registered with computational fluid dynamics (CFD) and finite element analysis (FEA) data.
  • Compartmental analysis of aneurysm dome, bleb, and neck was performed.

Main Results:

  • Areas with high 3D circumferential AWE (3D-CAWE) showed higher wall tension (WT) and time-averaged wall shear stress (TAWSS).
  • Aneurysm domes had lower WT, TAWSS, and wall shear stress gradient (WSSG) but higher oscillatory shear index (OSI) compared to the neck.
  • Blebs exhibited lower WT, TAWSS, OSI, and WSSG compared to non-enhanced sac areas.

Conclusions:

  • Focal high AWE in sacs and blebs correlates with low wall tension and low wall shear stress.
  • The aneurysm neck experiences higher mechanical load with average AWE and high wall tension/shear stress.
  • Distinct morphomechanical environments exist between the aneurysm dome and neck.