When an unruptured aneurysm is found, deciding whether to operate or follow up is one of the most important issues. There are guidelines for making the best final decision on treatment, taking into account the effecti...When an unruptured aneurysm is found, deciding whether to operate or follow up is one of the most important issues. There are guidelines for making the best final decision on treatment, taking into account the effectiveness of diagnostic and therapeutic devices and the risk-benefit ratio of patients, caregivers, and healthcare professionals. The guidelines evidence-based of large clinical data for this purpose are presented by national medical societies. As one of the rupture risk indicators, there is the hazard risk ratio derived by the UCAS Japan research group based on the statistical method of 6697 aneurysms in 5720 patients with cerebral aneurysms of 3 mm or more. Therefore, we investigated the biomechanical significance of this hazard risk ratio using a spherical aneurysm model. It was revealed that 1) the reason why the frequency of aneurysm rupture is relatively high up to about 10 mm, 2) the UCAS hazard risk ratio corresponds to stress of the aneurysm wall, and the true stress can be calculated by multiplying the patient’s blood pressure, and 3) the factors that cause the daughter’s sac (irregular protrusion of the aneurysm wall). In addition, our two methods for measuring the strength of the blood vessel wall of an individual patient were described.展开更多
The unpredictable rupture of saccular aneurysms especially of the intracerebral aneurysm is a knotty problem that always results in high mortality. Traditional diagnosis of medical images, which gives the aneurysm siz...The unpredictable rupture of saccular aneurysms especially of the intracerebral aneurysm is a knotty problem that always results in high mortality. Traditional diagnosis of medical images, which gives the aneurysm size and compares with a speculated critical size from clinical statistics, was demonstrated inadequate to forecasting rupture. Here, we propose a new detecting strategy that uses a dielectric elastomer （DE） capacitance sensor to monitor the growth of saccular aneurysms and deliver both the wall stress and geometric parameters, Based on the elastic growth theory together with the finite deformation analyses, the correlation between the real-time output capacitance of the DE sensor and the wall stress and/or geometry of an aneurysm is derived. Compared to clinic statistics and biomechanics simulations, the wall stress and geometric size may be used as combined indicators to assess the rupture risk of a saccular aneurysm, Numerical results show that an output relative capacitance of 30 indicates a high risk of rupture, Finally, the sensitivity and resolution of the DE sensor are proved adequately high for monitoring the growth state and evaluating the rupture risk of a saccular aneurysm.展开更多
Background Ventricular septal rupture （VSR） remains an infrequent but devastating complication of acute myocardial infarction （AMI）. The best time to undergo surgical repair is controversial and there is currently...Background Ventricular septal rupture （VSR） remains an infrequent but devastating complication of acute myocardial infarction （AMI）. The best time to undergo surgical repair is controversial and there is currently no risk stratification for patients with VSR to guide treatment. The purpose of this study was to review the clinical outcomes of 70 patients with VSR, to analyze the short-term prognosis factors of VSR following AMI, and to make a risk stratification for patients with VSR.展开更多
文摘When an unruptured aneurysm is found, deciding whether to operate or follow up is one of the most important issues. There are guidelines for making the best final decision on treatment, taking into account the effectiveness of diagnostic and therapeutic devices and the risk-benefit ratio of patients, caregivers, and healthcare professionals. The guidelines evidence-based of large clinical data for this purpose are presented by national medical societies. As one of the rupture risk indicators, there is the hazard risk ratio derived by the UCAS Japan research group based on the statistical method of 6697 aneurysms in 5720 patients with cerebral aneurysms of 3 mm or more. Therefore, we investigated the biomechanical significance of this hazard risk ratio using a spherical aneurysm model. It was revealed that 1) the reason why the frequency of aneurysm rupture is relatively high up to about 10 mm, 2) the UCAS hazard risk ratio corresponds to stress of the aneurysm wall, and the true stress can be calculated by multiplying the patient’s blood pressure, and 3) the factors that cause the daughter’s sac (irregular protrusion of the aneurysm wall). In addition, our two methods for measuring the strength of the blood vessel wall of an individual patient were described.
基金supported by the National Natural Science Foundation of China(11322216,11621062,and 11321202)the Zhejiang Provincial Natural Science Foundation(LR13A020001)
文摘The unpredictable rupture of saccular aneurysms especially of the intracerebral aneurysm is a knotty problem that always results in high mortality. Traditional diagnosis of medical images, which gives the aneurysm size and compares with a speculated critical size from clinical statistics, was demonstrated inadequate to forecasting rupture. Here, we propose a new detecting strategy that uses a dielectric elastomer （DE） capacitance sensor to monitor the growth of saccular aneurysms and deliver both the wall stress and geometric parameters, Based on the elastic growth theory together with the finite deformation analyses, the correlation between the real-time output capacitance of the DE sensor and the wall stress and/or geometry of an aneurysm is derived. Compared to clinic statistics and biomechanics simulations, the wall stress and geometric size may be used as combined indicators to assess the rupture risk of a saccular aneurysm, Numerical results show that an output relative capacitance of 30 indicates a high risk of rupture, Finally, the sensitivity and resolution of the DE sensor are proved adequately high for monitoring the growth state and evaluating the rupture risk of a saccular aneurysm.
文摘Background Ventricular septal rupture （VSR） remains an infrequent but devastating complication of acute myocardial infarction （AMI）. The best time to undergo surgical repair is controversial and there is currently no risk stratification for patients with VSR to guide treatment. The purpose of this study was to review the clinical outcomes of 70 patients with VSR, to analyze the short-term prognosis factors of VSR following AMI, and to make a risk stratification for patients with VSR.
