A predictive hemodynamic model based on risk factors for ruptured mirror aneurysms

Sheng-Qi Hu; Ru-Dong Chen; Wei-Dong Xu; Hua Li; Jia-Sheng Yu

doi:10.3389/fneur.2022.998557

A predictive hemodynamic model based on risk factors for ruptured mirror aneurysms

Front Neurol. 2022 Sep 9:13:998557. doi: 10.3389/fneur.2022.998557. eCollection 2022.

Authors

Sheng-Qi Hu¹, Ru-Dong Chen¹, Wei-Dong Xu¹, Hua Li¹, Jia-Sheng Yu¹

Affiliation

¹ Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Objectives: To identify hemodynamic risk factors for intracranial aneurysm rupture and establish a predictive model to aid evaluation.

Methods: We analyzed the hemodynamic parameters of 91 pairs of ruptured mirror aneurysms. A conditional univariate analysis was used for the continuous variables. A conditional multivariate logistic regression analysis was performed to identify the independent risk factors. Differences where p < 0.05 were statistically significant. A predictive model was established based on independent risk factors. Odds ratios (ORs) were used to score points. The validation cohort consisted of 189 aneurysms. Receiver operating characteristic curves were generated to determine the cutoff values and area under the curves (AUCs) of the predictive model and independent risk factors.

Results: The conditional multivariate logistic analysis showed that the low shear area (LSA) (OR = 70.322, p = 0.044, CI = 1.112-4,445.256), mean combined hemodynamic parameter (CHP) (>0.087) (OR = 3.171, p = 0.034, CI = 1.089-9.236), and wall shear stress gradient (WSSG) ratio (>893.180) (OR = 5.740, p = 0.003, CI = 1.950-16.898) were independent risk factors. A prediction model was established: 23^*LSA + 1^*CHP mean (>0.087: yes = 1, no = 0) + 2 ^* WSSG ratio (>893.180: yes = 1, no = 0). The AUC values of the predictive model, LSA, mean CHP (>0.087), and WSSG ratio (>893.180) were 0.748, 0.700, 0.654, and 0.703, respectively. The predictive model and LSA cutoff values were 1.283 and 0.016, respectively. In the validation cohort, the predictive model, LSA, CHP (>0.087), and WSSG ratio (>893.180) were 0.736, 0.702, 0.689, and 0.706, respectively.

Conclusions: LSA, CHP (>0.087), and WSSG ratio (>893.180) were independent risk factors for aneurysm rupture. Our predictive model could aid practical evaluation.

Keywords: combined hemodynamic parameter; low shear area; mirror aneurysm; predictive model; risk factors; wall shear stress gradient ratio.