| Part 1: Hemodynamics analysis of risk factors for rupture of internal carotid-ophthalmic aneurysmsObjective: The purpose of this study is to analyze the effect of hemodynamic parameters and morphology between irregular and regular ophthalmic segment aneurysms by computational fluid dynamics(CFD)technology.Methods: The medical records of 76 patients with unruptured intracranial carotidophthalmic aneurysms admitted to the Department of the Affiliated Hospital of Qingdao University from January 2019-October 2022 were retrospectively analyzed,who were divided into regular aneurysms group(39 cases)and irregular aneurysms group(37 cases)according to their morphology.All patients underwent three-dimensional rotational cerebral angiography and computational fluid dynamics(CFD)simulations.The data was analyzed using Mann-Whitney U test and performed multivariate logistic regression analysis to identify predictors.Then,aneurysms in the irregular group were divided into three subgroups,namely bleb type,lobus type and other type.Hemodynamic and morphological parameters were compared and analyzed using Kruskal Wallis test in irregular subgroup.Results: The mean wall shear stress(WSS)and the normalized mean wall shear stress(WSS)of the irregular group were significantly lower than that in the regular group,and the irregular group had higher oscillatory shear index(OSI)(P<0.05).OSI100(OSI100=100*OSI)was an independent risk factor for irregular aneurysms(OR=1.83,P=0.03).Lobus type had higher parent artery WSS than another type in irregular group(H=8.13,P=0.01).Conclusion: Hemodynamics played an important role in the drown of irregular ophthalmic segment aneurysms,OSI was independently associated with the development of ophthalmic aneurysms morphology.Parent artery WSS may might significantly alter aneurysm geometry.Hemodynamics provided objective metrics to assess aneurysm formation risk of irregular morphology in patients.Part 2: Lipids and inflammatory peripheral blood cell ratios analysis of risk factors for rupture of internal carotid-ophthalmic aneurysmsObjective: There are various factors of the growth of an aneurysm.Dyslipidemia and Inflammation played an important role in the development of aneurysms and have been recognized as a pivotal characteristic prophetical of rupture of cerebral aneurysm.However,the contribution of lipids and inflammatory peripheral blood cell ratios in patients with unruptured ophthalmic artery segmental aneurysms has not been well defined.In this study,we retrospectively collected blood lipids and inflammatory peripheral blood cell ratios from patients with ophthalmic artery segmental aneurysms,aiming to investigate the relationship between the morphology and blood markers..Methods: The retrospective study population included 112 patients with unruptured intracranial carotid-ophthalmic aneurysms admitted to the Department of the Affiliated Hospital of Qingdao University from January 2019-October 2022.They were divided into regular aneurysms group(54 cases)and irregular aneurysms group(58 cases)according to their morphology.Elevated triglycerides(TGs),total cholesterol(TC),Apo-A1,Apo-B,APOB/APOA,high-density lipoprotein(HDL),low-density lipoprotein(LDL),lipoprotein a,SII index(neutrophils × platelets/lymphocytes),Neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)were compared between regular aneurysms group and irregular aneurysms group..Results: We observed that irregular intracranial ophthalmic aneurysms group was related with the higher blood levels of total cholesterol(Z=-0.714,P=0.026)and lower neutrophil-to-lymphocyte ratio(Z=-1.597,P=0.036)in a study of lipids and inflammatory peripheral blood cell ratios.Conclusion:We demonstrated that lipids and inflammatory peripheral blood cell ratios are associated with irregular carotid-ophthalmic aneurysms.These readily available biomarkers may be valuable for predict risk stratification in patients with carotid-ophthalmic aneurysms. |
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