Evidence map›Paper›PMID 30915482›Full record

ArticleClinical neuroradiology2019

The unexplained success of stentplasty vasospasm treatment : Insights using Mechanistic Mathematical Modeling.

P Bhogal, G Pederzani, A Grytsan, Y Loh, P A Brouwer, T Andersson, Namrata Gundiah, Anne M Robertson, Paul N Watton, Michael Söderman

Erratum issuedOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical neuroradiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
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  8. Treatment of cerebral vasospasm secondary to subarachnoid hemorrhage utilizing the Comaneci device.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2020
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 5 countries.

P BhogalDepartment of Interventional Neuroradiology, The Royal London Hospital, Whitechapel Road, E1 1BB, London, UK. bhogalweb@aol.com.ORCID http://orcid.org/0000-0002-5514-5237
G PederzaniDepartment of Computer Science, University of Sheffield, Sheffield, UK.
A GrytsanInsigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK.
Y LohUniformed Services University, University of California, Los Angeles, USA.
P A BrouwerThe Karolinska University Hospital, 171 76, Stockholm, Sweden.
T AnderssonThe Karolinska University Hospital, 171 76, Stockholm, Sweden.
Namrata GundiahDepartment of Mechanical Engineering, Indian Institute of Science, Bangalore, India.
Anne M RobertsonDepartment of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA.
Paul N WattonDepartment of Computer Science, University of Sheffield, Sheffield, UK.
Michael SödermanThe Karolinska University Hospital, 171 76, Stockholm, Sweden.
Karolinska University Hospital · SEInsigneo · GBUniversity of Pittsburgh · USIndian Institute of Science Bangalore · INRoyal London Hospital · GBUniformed Services University of the Health Sciences · US

Funding

Improving Cerebral Aneurysm Risk Assessment through Understanding Wall Vulnerability and Failure ModesR01NS097457 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CEBRAL, JUAN R, ROBERTSON, ANNE MARIE · 2016 to 2025
$6.0M
NINDS NIH HHS R01 NS097457softmech UK EPSRC (EP/N014642/1).
6 · The paper itself

Abstract

backgroundCerebral vasospasm (CVS) following subarachnoid hemorrhage occurs in up to 70% of patients. Recently, stents have been used to successfully treat CVS. This implies that the force required to expand spastic vessels and resolve vasospasm is lower than previously thought.

objectiveWe develop a mechanistic model of the spastic arterial wall to provide insight into CVS and predict the forces required to treat it. MATERIAL AND

methodsThe arterial wall is modelled as a cylindrical membrane using a constrained mixture theory that accounts for the mechanical roles of elastin, collagen and vascular smooth muscle cells (VSMC). We model the pressure diameter curve prior to CVS and predict how it changes following CVS. We propose a stretch-based damage criterion for VSMC and evaluate if several commercially available stents are able to resolve vasospasm.

resultsThe model predicts that dilatation of VSMCs beyond a threshold of mechanical failure is sufficient to resolve CVS without damage to the underlying extracellular matrix. Consistent with recent clinical observations, our model predicts that existing stents have the potential to provide sufficient outward force to successfully treat CVS and that success will be dependent on an appropriate match between stent and vessel.

conclusionMathematical models of CVS can provide insights into biological mechanisms and explore treatment approaches. Improved understanding of the underlying mechanistic processes governing CVS and its mechanical treatment may assist in the development of dedicated stents.

Indexed as

Models, CardiovascularStentsAngioplastyBiomechanical PhenomenaBlood PressureCerebral ArteriesExtracellular MatrixHumansMuscle, Smooth, VascularMyocytes, Smooth MuscleSubarachnoid HemorrhageVasospasm, IntracranialMathematical modelingStentStentplastyVascular smooth muscle cellsVasospasm

Identifiers

PMID30915482
PMCPMC7158575
OpenAlexW2923270728

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.