More articles from Neurointervention
- Identification of Vortex Cores in Cerebral Aneurysms on 4D Flow MRI
The authors subjected 40 aneurysms (37 unruptured, 3 ruptured) to 4D flow MR imaging. They visualized streamlines with velocities below the threshold—that is, a percentage value of the aneurysm maximum inflow velocity—and progressively decreased the threshold to identify vortex cores as thin, streamline bundles with minimum velocities. A simple flow pattern (single vortex core) was identified in 27 aneurysms; the other 13 exhibited a complex flow pattern. The cores were stable in 32 and unstable in 8 aneurysms. Significantly more aneurysms with-than-without blebs or daughter sacs had a complex flow pattern. The identification of vortex cores on 4D flow MR imaging may help to stratify the rupture risk of unruptured cerebral aneurysms.
- Hemodynamic Analysis of Postoperative Rupture of Unruptured Intracranial Aneurysms after Placement of Flow-Diverting Stents: A Matched Case-Control Study
The authors enrolled 10 patients with intracranial aneurysms, treated with flow diverters between September 2014 and December 2018, who experienced postoperative aneurysm rupture. They matched these subjects 1:2 with 20 with postoperative unruptured intracranial aneurysms based on clinical and morphologic factors. Using computational fluid dynamics, they assessed hemodynamic changes pre- and posttreatment between the 2 groups on a number of qualitative and quantitative parameters. Compared with pretreatment, unstable flow pattern and higher energy loss after Pipeline Embolization Device placement for intracranial aneurysm may be the important hemodynamic risk factors related to delayed aneurysm rupture.