Abstract
Background: Delayed cerebral ischemia (DCI) is a significant cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). Recently, we reported the possibility that computational fluid dynamics (CFD) could predict DCI in terms of the cross-sectional area and flow velocity of the ipsilateral extracranial internal carotid and distal parent arteries in a single-center retrospective study.
Methods: This is a multicenter, prospective, cohort study. Patients with aneurysmal SAH will undergo CFD analyses using preoperative three-dimensional computed tomography angiography, and we will investigate hemodynamic features of cerebral arteries in an acute stage of SAH. Primary outcome measures will be CFD features in patients with subsequent occurrence of DCI. Secondary outcome measures will be CFD features in patients with subsequent occurrence of cerebral vasospasm and cerebral infarction and the relationships with eventual modified Rankin scale score at 3 months.
Conclusions: The present protocol for a multicenter prospective study is expected to provide a novel diagnostic method to predict DCI before aneurysmal obliteration in an acute stage of SAH.
CFD3 Study Group; Masato Shiba, Hidenori Suzuki, Ryuta Yasuda, Naoki Toma, Takeshi Okada, Hirofumi Nishikawa, Yoichi Miura (Mie University Graduate School of Medicine); Fujimaro Ishida (Mie Central Medical Center); Hiroshi Tanemura, Fumitaka Miya (Ise Red Cross Hospital); Yoshinari Nakatsuka, Tomohiro Araki (Suzuka Kaisei Hospital); Yusuke Nishikawa, Mitsuhito Mase (Nagoya City University Graduate School of Medicine); Yuichiro Kikkawa, Hiroki Kurita (Saitama Medical University International Medical Center); Hidenori Ohbuchi, Hidetoshi Kasuya (Tokyo Women’s Medical University Medical Center East); Takuji Yamamoto (Juntendo University Shizuoka Hospital); Yoko Kato (Fujita Health University Banbuntane Hotokukai Hospital); and Satoshi Iwabuchi (Toho University Medical Center Ohashi Hospital).
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Acknowledgments
This study is supported in part by a grant-in-aid for Scientific Research from Japan Society for the Promotion of Science to Drs. Shiba and Suzuki.
Conflict of Interest: The authors declare that they have no conflict of interest.
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Shiba, M. et al. (2020). Role of Computational Fluid Dynamics for Predicting Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: Study Protocol for a Multicenter Prospective Study. In: Martin, R., Boling, W., Chen, G., Zhang, J. (eds) Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 127. Springer, Cham. https://doi.org/10.1007/978-3-030-04615-6_24
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