ArticleBMC neurology2021
Wall shear stress gradient is independently associated with middle cerebral artery aneurysm development: a case-control CFD patient-specific study based on 77 patients.
Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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19 citing papers in PubMed, 31 citations in OpenAlex.
- GN-Net: A Geometric and Neighborhood-Aware Network for Predicting Intracranial Aneurysm Rupture Risk and Assisting Clinical Decision-Making.Interdisciplinary sciences, computational life sciences · 2026Article
- Middle Cerebral Artery Bifurcation Geometry and Aneurysm Formation: A Propensity Score-Matched 3D Rotational Morphometry Study.Diagnostics (Basel, Switzerland) · 2026Article
- Evaluating the role of graft angle on cerebral hemodynamics following direct cerebral bypass for moyamoya disease.PloS one · 2026Article
- Using Patient-Based Computational Fluid Dynamics for Abdominal Aortic Aneurysm Assessment.Bioengineering (Basel, Switzerland) · 2025Article
- Molecular Targets for Intracranial Aneurysm Treatment.International journal of molecular sciences · 2025Review
- Amplification of Secondary Flow at the Initiation Site of Intracranial Sidewall Aneurysms.Cardiovascular engineering and technology · 2025Article
- Single-Stage Microsurgical Clipping of Multiple Intracranial Aneurysms in a Patient with Cerebral Atherosclerosis: A Case Report and Review of Surgical Management.Journal of clinical medicine · 2025Article
- Drill turn technique for enhanced visualization of wide-neck bifurcation aneurysms in Y-stent-assisted coiling with LVIS EVO stents: technical considerations and mid-term results.Neuroradiology · 2025Observational
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- Aneurysm Formation at the Internal Carotid Artery Bifurcation Is Related to the Vascular Geometry of the Bifurcation.Brain sciences · 2024Article
- Fluid-Structure Interaction Simulations of the Initiation Process of Cerebral Aneurysms.Brain sciences · 2024Article
- Investigation of paraclinoid aneurysm formation by comparing the combined influence of hemodynamic parameters between aneurysmal and non-aneurysmal arteries.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Investigating the pathophysiology and evolution of internal carotid dissection: a fluid-structure interaction simulation study.Frontiers in neurology · 2024Article
- 3D bioprinted multilayered cerebrovascular conduits to study cancer extravasation mechanism related with vascular geometry.Nature communications · 2023Article
- Studying the imaging features and infarction mechanism of vertebrobasilar dolichoectasia with high-resolution magnetic resonance imaging.Brain pathology (Zurich, Switzerland) · 2023Article
- Advanced cross-sectional imaging of cerebral aneurysms.The British journal of radiology · 2023Review
- Characteristics and evaluation of atherosclerotic plaques: an overview of state-of-the-art techniques.Frontiers in neurology · 2023Review
- Morphometry of cerebral arterial bifurcations harbouring aneurysms: a case-control study.BMC neurology · 2022Article
- A predictive hemodynamic model based on risk factors for ruptured mirror aneurysms.Frontiers in neurology · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
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Abstract
backgroundPreviously published computational fluid dynamics (CFD) studies regarding intracranial aneurysm (IA) formation present conflicting results. Our study analysed the involvement of the combination of high wall shear stress (WSS) and a positive WSS gradient (WSSG) in IA formation.
methodsWe designed a case-control study with a selection of 38 patients with an unruptured middle cerebral artery (MCA) aneurysm and 39 non-aneurysmal controls to determine the involvement of WSS, oscillatory shear index (OSI), the WSSG and its absolute value (absWSSG) in aneurysm formation based on patient-specific CFD simulations using velocity profiles obtained from transcranial colour-coded sonography.
resultsAmong the analysed parameters, only the WSSG had significantly higher values compared to the controls (11.05 vs - 14.76 [Pa/mm], P = 0.020). The WSS, absWSSG and OSI values were not significantly different between the analysed groups. Logistic regression analysis identified WSS and WSSG as significant co-predictors for MCA aneurysm formation, but only the WSSG turned out to be a significant independent prognosticator (OR: 1.009; 95% CI: 1.001-1.017; P = 0.025). Significantly more patients (23/38) in the case group had haemodynamic regions of high WSS combined with a positive WSSG near the bifurcation apex, while in the control group, high WSS was usually accompanied by a negative WSSG (14/39). From the analysis of the ROC curve for WSSG, the area under the curve (AUC) was 0.654, with the optimal cut-off value -0.37 Pa/mm. The largest AUC was recognised for combined WSS and WSSG (AUC = 0.671). Our data confirmed that aneurysms tend to form near the bifurcation apices in regions of high WSS values accompanied by positive WSSG.
conclusionsThe development of IAs is determined by an independent effect of haemodynamic factors. High WSS impacts MCA aneurysm formation, while a positive WSSG mainly promotes this process.
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