{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1360004239317065728.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.3171/2018.12.jns182897"}},{"identifier":{"@type":"URI","@value":"https://thejns.org/view/journals/j-neurosurg/132/4/article-p1116.xml"}},{"identifier":{"@type":"URI","@value":"https://thejns.org/downloadpdf/journals/j-neurosurg/132/4/article-p1116.xml"}},{"identifier":{"@type":"PMID","@value":"30875692"}}],"resourceType":"学術雑誌論文(journal article)","dc:title":[{"@value":"Decreased wall shear stress at high-pressure areas predicts the rupture point in ruptured intracranial aneurysms"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>Degenerative cerebral aneurysm walls are associated with aneurysm rupture and subarachnoid hemorrhage. Thin-walled regions (TWRs) represent fragile areas that may eventually lead to aneurysm rupture. Previous computational fluid dynamics (CFD) studies reported the correlation of maximum pressure (Pmax) areas and TWRs; however, the correlation with aneurysm rupture has not been established. This study aims to investigate this hemodynamic correlation.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>The aneurysmal wall surface at the Pmax areas was intraoperatively evaluated using a fluid flow formula under pulsatile blood flow conditions in 23 patients with 23 saccular middle cerebral artery (MCA) bifurcation aneurysms (16 unruptured and 7 ruptured). The pressure difference (Pd) at the Pmax areas was calculated by subtracting the average pressure (Pave) from the Pmax and normalized by dividing this by the dynamic pressure at the aneurysm inlet side. The wall shear stress (WSS) was also calculated at the Pmax areas, aneurysm dome, and parent artery. These hemodynamic parameters were used to validate the correlation with TWRs in unruptured MCA aneurysms. The characteristic hemodynamic parameters at the rupture points in ruptured MCA aneurysms were then determined.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>In 13 of 16 unruptured aneurysms (81.2%), Pmax areas were identified that corresponded to TWRs. In 5 of the 7 ruptured cerebral aneurysms, the Pmax areas coincided with the rupture point. At these areas, the Pd values were not higher than those of the TWRs in unruptured cerebral aneurysms; however, minimum WSS, time-averaged WSS, and normalized WSS at the rupture point were significantly lower than those of the TWRs in unruptured aneurysms (p < 0.01).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>At the Pmax area of TWRs, decreased WSS appears to be the crucial hemodynamic parameter that indicates the risk of aneurysm rupture.</jats:p></jats:sec>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1380004239317065856","@type":"Researcher","foaf:name":[{"@value":"Tomoaki Suzuki"}],"jpcoar:affiliationName":[{"@value":"Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;"},{"@value":"Department of Neurosurgery, Jikei University School of Medicine, Tokyo;"},{"@value":"Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065860","@type":"Researcher","foaf:name":[{"@value":"Christopher J. Stapleton"}],"jpcoar:affiliationName":[{"@value":"Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065993","@type":"Researcher","foaf:name":[{"@value":"Matthew J. Koch"}],"jpcoar:affiliationName":[{"@value":"Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065728","@type":"Researcher","foaf:name":[{"@value":"Kazutoshi Tanaka"}],"jpcoar:affiliationName":[{"@value":"Graduate School of Mechanical Engineering, Tokyo University of Science, Tokyo;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065857","@type":"Researcher","foaf:name":[{"@value":"Soichiro Fujimura"}],"jpcoar:affiliationName":[{"@value":"Graduate School of Mechanical Engineering, Tokyo University of Science, Tokyo;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065988","@type":"Researcher","foaf:name":[{"@value":"Takashi Suzuki"}],"jpcoar:affiliationName":[{"@value":"Graduate School of Mechanical Engineering, Tokyo University of Science, Tokyo;"},{"@value":"Department of Innovation for Medical Information Technology, Jikei University School of Medicine, Tokyo; and"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065989","@type":"Researcher","foaf:name":[{"@value":"Takeshi Yanagisawa"}],"jpcoar:affiliationName":[{"@value":"Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;"},{"@value":"Department of Neurosurgery, Jikei University School of Medicine, Tokyo;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065729","@type":"Researcher","foaf:name":[{"@value":"Makoto Yamamoto"}],"jpcoar:affiliationName":[{"@value":"Department of Mechanical Engineering, Tokyo University of Science, Tokyo, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1030003658429285376","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"40283014"},{"@type":"NRID","@value":"1000040283014"},{"@type":"NRID","@value":"9000405028902"},{"@type":"NRID","@value":"9000414744302"},{"@type":"NRID","@value":"9000400171269"},{"@type":"NRID","@value":"9000404318751"},{"@type":"NRID","@value":"9000410743539"},{"@type":"NRID","@value":"9000396152001"},{"@type":"NRID","@value":"9000403161916"},{"@type":"NRID","@value":"9000405028926"},{"@type":"NRID","@value":"9000408791749"},{"@type":"NRID","@value":"9000344125975"},{"@type":"NRID","@value":"9000389444692"},{"@type":"NRID","@value":"9000301717421"},{"@type":"NRID","@value":"9000414928273"},{"@type":"NRID","@value":"9000378649612"}],"foaf:name":[{"@value":"Yukihiko Fujii"}],"jpcoar:affiliationName":[{"@value":"Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065992","@type":"Researcher","foaf:name":[{"@value":"Yuichi Murayama"}],"jpcoar:affiliationName":[{"@value":"Department of Neurosurgery, Jikei University School of Medicine, Tokyo;"}]},{"@id":"https://cir.nii.ac.jp/crid/1380004239317065986","@type":"Researcher","foaf:name":[{"@value":"Aman B. Patel"}],"jpcoar:affiliationName":[{"@value":"Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"00223085"},{"@type":"EISSN","@value":"19330693"}],"prism:publicationName":[{"@value":"Journal of Neurosurgery"}],"dc:publisher":[{"@value":"Journal of Neurosurgery Publishing Group (JNSPG)"}],"prism:publicationDate":"2020-04","prism:volume":"132","prism:number":"4","prism:startingPage":"1116","prism:endingPage":"1122"},"reviewed":"false","url":[{"@id":"https://thejns.org/view/journals/j-neurosurg/132/4/article-p1116.xml"},{"@id":"https://thejns.org/downloadpdf/journals/j-neurosurg/132/4/article-p1116.xml"}],"createdAt":"2019-04-09","modifiedAt":"2022-07-25","project":[{"@id":"https://cir.nii.ac.jp/crid/1040000781961401344","@type":"Project","projectIdentifier":[{"@type":"KAKEN","@value":"17J07496"},{"@type":"JGN","@value":"JP17J07496"},{"@type":"URI","@value":"https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17J07496/"}],"notation":[{"@language":"ja","@value":"脳動脈瘤のコイル塞栓手術に対する術式アシストシステムの開発"},{"@language":"en","@value":"Development of assist system for coil embolization in cerebral aneurysm"}]},{"@id":"https://cir.nii.ac.jp/crid/1040282256946219648","@type":"Project","projectIdentifier":[{"@type":"KAKEN","@value":"17K10888"},{"@type":"JGN","@value":"JP17K10888"},{"@type":"URI","@value":"https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17K10888/"}],"notation":[{"@language":"ja","@value":"7T-MRIを用いた「MRI陰性新皮質てんかん」の焦点可視化に関する学際的検討"},{"@language":"en","@value":"Visualization of epileptogenic foci of MRI non-lesional neocortical epilepsy patients by 7T-MRI"}]}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360004232554271744","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Using Computational Fluid Dynamics Analysis to Characterize Local Hemodynamic Features of Middle Cerebral Artery Aneurysm Rupture Points"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011146530832128","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Translucent Appearance of Middle Cerebral Artery Bifurcation Aneurysms Is Risk Factor for Intraoperative Aneurysm Rupture During Clipping"}]},{"@id":"https://cir.nii.ac.jp/crid/1360290617446747264","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Inflow Hemodynamics of Intracranial Aneurysms: A Comparison of Computational Fluid Dynamics and 4D Flow Magnetic Resonance Imaging"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292620275723264","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Colocalization of thin-walled dome regions with low hemodynamic wall shear stress in unruptured cerebral aneurysms"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292621376490496","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Detection of Pulsation in Ruptured and Unruptured Cerebral Aneurysms by Electrocardiographically Gated 3-Dimensional Computed Tomographic Angiography With a 320-Row Area Detector Computed Tomography and Evaluation of Its Clinical Usefulness"}]},{"@id":"https://cir.nii.ac.jp/crid/1360565169042606848","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Determining the Presence of Thin-Walled Regions at High-Pressure Areas in Unruptured Cerebral Aneurysms by Using Computational Fluid Dynamics"}]},{"@id":"https://cir.nii.ac.jp/crid/1360572092475170176","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Hemodynamic features of an intracranial aneurysm rupture predicted by perianeurysmal edema: A case report"}]},{"@id":"https://cir.nii.ac.jp/crid/1360576118813654528","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Virtual test occlusion for assessing ischemic tolerance using computational fluid dynamics"}]},{"@id":"https://cir.nii.ac.jp/crid/1360584341840936832","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Hemodynamics in Intracranial Aneurysm Formation"}]},{"@id":"https://cir.nii.ac.jp/crid/1360855570453634560","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Does Aneurysmal Wall Enhancement on Vessel Wall MRI Help to Distinguish Stable From Unstable Intracranial Aneurysms?"}]},{"@id":"https://cir.nii.ac.jp/crid/1360855570713735680","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Hemodynamic changes in a middle cerebral artery aneurysm at follow-up times before and after its rupture: a case report and a review of the literature"}]},{"@id":"https://cir.nii.ac.jp/crid/1360857593699559808","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Computational fluid dynamic analysis of the initiation of cerebral aneurysms"}]},{"@id":"https://cir.nii.ac.jp/crid/1360869856045938048","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Hemodynamics in Cerebral Aneurysms and Parent Arteries With Incompletely Expanded Flow Diverter Stents"}]},{"@id":"https://cir.nii.ac.jp/crid/1361137043425868928","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Delayed aneurysm rupture due to residual blood flow at the inflow zone of the intracranial paraclinoid internal carotid aneurysm treated with the Pipeline embolization device: Histopathological investigation"}]},{"@id":"https://cir.nii.ac.jp/crid/1361137046410796928","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Hemodynamic Characteristics at the Rupture Site of Cerebral Aneurysms"}]},{"@id":"https://cir.nii.ac.jp/crid/1361418518697952768","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Unruptured intracranial aneurysms: development, rupture and preventive management"}]},{"@id":"https://cir.nii.ac.jp/crid/1361418521163482368","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Association of Hemodynamic Characteristics and Cerebral Aneurysm Rupture"}]},{"@id":"https://cir.nii.ac.jp/crid/1362262943814552576","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Risk of Rupture of Unruptured Intracranial Aneurysms in Relation to Patient and Aneurysm Characteristics"}]},{"@id":"https://cir.nii.ac.jp/crid/1362825894523864960","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Observation of cerebral aneurysm wall thickness using intraoperative microscopy: clinical and morphological analysis of translucent aneurysm"}]},{"@id":"https://cir.nii.ac.jp/crid/1362825896331427968","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Structural Fragility and Inflammatory Response of Ruptured Cerebral Aneurysms"}]},{"@id":"https://cir.nii.ac.jp/crid/1363107368724523136","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"How does spontaneous hemostasis occur in ruptured cerebral aneurysms? Preliminary investigation on 247 clipping surgeries"}]},{"@id":"https://cir.nii.ac.jp/crid/1363107370208298240","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Rupture of giant vertebrobasilar aneurysm following flow diversion: mechanical stretch as a potential mechanism for early aneurysm rupture"}]},{"@id":"https://cir.nii.ac.jp/crid/1363388844722590336","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Remodeling of Saccular Cerebral Artery Aneurysm Wall Is Associated With Rupture"}]},{"@id":"https://cir.nii.ac.jp/crid/1363670318669393152","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Hemodynamic–Morphologic Discriminants for Intracranial Aneurysm Rupture"}]},{"@id":"https://cir.nii.ac.jp/crid/1363670320799469568","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The Effect of Pressure-Induced Mechanical Stretch on Vascular Wall Differential Gene Expression"}]},{"@id":"https://cir.nii.ac.jp/crid/1363951795739101568","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Cerebral aneurysm wall thickness analysis using intraoperative microscopy: effect of size and gender on thin translucent regions"}]},{"@id":"https://cir.nii.ac.jp/crid/1364233268632966912","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Low wall shear stress is associated with the rupture of intracranial aneurysm with known rupture point: case report and literature review"}]},{"@id":"https://cir.nii.ac.jp/crid/1364233269903047552","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Flow Conditions in the Intracranial Aneurysm Lumen Are Associated with Inflammation and Degenerative Changes of the Aneurysm Wall"}]},{"@id":"https://cir.nii.ac.jp/crid/1390305046533311616","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"High Middle Cerebral Artery Wall Shear Stress in Branch Atheromatous Disease: A Computational Fluid Dynamics Analysis"}]},{"@id":"https://cir.nii.ac.jp/crid/1390577917543674112","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Computational Fluid Dynamics Analysis Features in Aneurysm Development in Rats"}]}],"dataSourceIdentifier":[{"@type":"CROSSREF","@value":"10.3171/2018.12.jns182897"},{"@type":"KAKEN","@value":"PRODUCT-22394354"},{"@type":"KAKEN","@value":"PRODUCT-22648678"},{"@type":"KAKEN","@value":"PRODUCT-22071791"},{"@type":"OPENAIRE","@value":"doi_dedup___::ddc0d1e1cf5416e718933c8e3ea4cb5d"},{"@type":"CROSSREF","@value":"10.1016/j.jstrokecerebrovasdis.2021.105685_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"},{"@type":"CROSSREF","@value":"10.3171/2021.8.jns211452_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"},{"@type":"CROSSREF","@value":"10.2176/jns-nmc.2023-0005_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"},{"@type":"CROSSREF","@value":"10.5551/jat.65439_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"},{"@type":"CROSSREF","@value":"10.25259/sni_780_2020_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"},{"@type":"CROSSREF","@value":"10.25259/sni_439_2021_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"},{"@type":"CROSSREF","@value":"10.5772/intechopen.114925_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"},{"@type":"CROSSREF","@value":"10.1002/cnm.70033_references_DOI_JhRHEoN77O3IY1yUlns7QDNux34"}]}