Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Anesthesiology, The Military General Hospital of Beijing PLA, Beijing, China.
Sci Rep. 2017 Jul 13;7(1):5331. doi: 10.1038/s41598-017-05886-w.
To evaluate the relationship between wall shear stress (WSS) magnitude and cerebral aneurysm rupture and provide new insight into the disparate computational fluid dynamics (CFD) findings concerning the role of WSS in intracranial aneurysm (IA) rupture. A systematic electronic database (PubMed, Medline, Springer, and EBSCO) search was conducted for all accessible published articles up to July 1, 2016, with no restriction on the publication year. Abstracts, full-text manuscripts, and the reference lists of retrieved articles were analyzed. Random effects meta-analysis was used to pool the complication rates across studies. Twenty-two studies containing CFD data on 1257 patients with aneurysms were included in the analysis. A significantly higher rate of low WSS (0-1.5 Pa) was found in ruptured aneurysms (odds ratio [OR] 2.17; 95% confidence interval [CI], 1.73-2.62). The pooled analyses across 14 studies with low WSS showed significantly lower mean WSS (0.64 vs. 1.4 Pa) (p = 0.037) in the ruptured group. This meta-analysis provides evidence that decreased local WSS may be an important predictive parameter of IA rupture.
为了评估壁面切应力（WSS）大小与脑动脉瘤破裂之间的关系，并深入了解有关 WSS 在颅内动脉瘤（IA）破裂中的作用的不同计算流体动力学（CFD）研究结果，我们进行了系统的电子数据库（PubMed、Medline、Springer 和 EBSCO）检索，检索时间截至 2016 年 7 月 1 日，没有对发表年份进行限制。分析了摘要、全文手稿和检索文章的参考文献列表。采用随机效应荟萃分析来汇总研究间的并发症发生率。共纳入了 22 项研究，这些研究包含了 1257 例动脉瘤患者的 CFD 数据。破裂动脉瘤中低 WSS（0-1.5 Pa）的发生率明显更高（比值比[OR] 2.17；95%置信区间[CI]，1.73-2.62）。对 14 项具有低 WSS 的研究进行的汇总分析显示，破裂组的平均 WSS（0.64 vs. 1.4 Pa）明显较低（p = 0.037）。本荟萃分析提供了证据表明，局部 WSS 的降低可能是 IA 破裂的一个重要预测参数。
