Fluid Dynamics Computational Hemodynamic Analysis High Level Risk Factors For Ruptured Intracranial Aneurysm

Objective:Collecting the general data,morphological parameters and hemodynamics parameters of low-grade and high-grade intracranial aneurysms is used to analyze the risk factors of rupture of high-grade aneurysms,which can be used as a reference for clinical work to evaluate the high grade cerebral aneurysm rupture risk.Methods:A total of 64 patients of intracranial aneurysms treated by the Department of Neurosurgery of Hulunbuir City People’s Hospital from July 2020 to March 2022were collected and grouped according to the Hunt-Hess classification(Table 1),including 21 cases in the high-grade aneurysm group and 43 cases in the low-grade aneurysm group.The author collects the patient’s general information and ensures whether once the patient have had hypertension,smoking and alcohol consumption or not,collecting intracranial aneurysm morphological parameters AR value,(tumor body/neck,shown in Figure 1),size and other data.After these,the author uses each patient’s iconography data(computed tomographic angiography,total cerebral angiography,magnetic resonance angiography)to construct three-dimensional models and then conducts Computational Fluid Dynamics(CFD)numerical simulation to acquire patients’hemodynamic parameters,including Wall Shear Stress(WSS)and Oscillatory Shear Index(OSI).Besides,inter-group single factor analysis is performed and logistic regression analysis will be performed to find risk factors if the variate has statistical significances for single factor analysis.(TabResults:The author analyzes the data of 64 patients with ruptured aneurysm,which includes 21 patients in high-grade aneurysm group and 43 patients in low-grade aneurysm group.The results of the univariate analysis shows that the differences of history of hypertension(X~2=5.75,P=0.02),aneurysm size(t=26.32,P<0.001),WSS(t=-2.28,P<0.001),AR value(t=-6.06,P<0.001)have statistical significance.And the differences of men(X~2=3.072,P=0.090),age(t=-0.96,P=0.34),diabetes(X~2=0.04,P=0.841),history of alcohol consumption(X~2=4.581,P=0.032),history of smoking(X~2=0.020,P=0.88),aneurysm location(X~2=26.32,P=1.00),OSI(t=1.167,P=0.248),hematocrit(t=-0.447,P=0.637),red blood cell count(0t=0.639,P=0.525)do not achieve statistical significance.Cases with statistically significant differences in univariate analysis were analyzed for logistic regression,and then the author discovered that hypertension(OR=11.788,95%CI1.059-13.154,P=0.045),WSS(OR=8.702,95%CI 1.014-74.645,P=0.048),aneurysm(OR=3.963,95%CI 1.094-14.735,P=0.036)are significantly associated with the risk of rupture of high-grade intracranial aneurysms.Conclusion:High-grade aneurysm rupture is associated with Wall Shear Stress (WSS),hypertension,AR value,and aneurysm size,among which Wall Shear Stress(WSS),hypertension,and aneurysm size are the risk factors of rupture of high-grade intracranial aneurysm.