Evaluation of aneurysm rupture risk based upon flowrate-independent hemodynamic parameters: a multi-center pilot study.
J Neurointerv Surg
; 15(7): 695-700, 2023 Jul.
Article
en En
| MEDLINE
| ID: mdl-35688619
ABSTRACT
BACKGROUND:
Specifying generic flow boundary conditions in aneurysm hemodynamic simulations yields a great degree of uncertainty for the evaluation of aneurysm rupture risk. Herein, we proposed the use of flowrate-independent parameters in discriminating unstable aneurysms and compared their prognostic performance against that of conventional absolute parameters.METHODS:
This retrospective study included 186 aneurysms collected from three international centers, with the stable aneurysms having a minimum follow-up period of 24 months. The flowrate-independent aneurysmal wall shear stress (WSS) and energy loss (EL) were defined as the coefficients of the second-order polynomials characterizing the relationships between the respective parameters and the parent-artery flows. Performance of the flowrate-independent parameters in discriminating unstable aneurysms with the logistic regression, Adaboost, and support-vector machine (SVM) methods was quantified and compared against that of the conventional parameters, in terms of sensitivity, specificity, and area under the curve (AUC).RESULTS:
In discriminating unstable aneurysms, the proposed flowrate-independent EL achieved the highest sensitivity (0.833, 95% CI 0.586 to 0.964) and specificity (0.833, 95% CI 0.672 to 0.936) on the SVM, with the AUC outperforming the conventional EL by 0.133 (95% CI 0.039 to 0.226, p=0.006). Likewise, the flowrate-independent WSS outperformed the conventional WSS in terms of the AUC (difference 0.137, 95% CI 0.033 to 0.241, p=0.010).CONCLUSION:
The flowrate-independent hemodynamic parameters surpassed their conventional counterparts in predicting the stability of aneurysms, which may serve as a promising set of hemodynamic metrics to be used for the prediction of aneurysm rupture risk when physiologically real vascular boundary conditions are unavailable.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Aneurisma Intracraneal
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Aneurisma Roto
Tipo de estudio:
Clinical_trials
/
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
J Neurointerv Surg
Año:
2023
Tipo del documento:
Article
País de afiliación:
Australia