Computational fluid dynamic analysis of intracranial aneurysmal bleb formation
| Autor: | David Fletcher, Mark D. Barry, Jeremy Russell, Mark J. Pearcy, Neil A. Kelson, Craig Winter |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty genetic structures Hemodynamics Wall pressure computational fluid dynamics hemodynamics oscillatory shear index 010300 NUMERICAL AND COMPUTATIONAL MATHEMATICS Imaging Three-Dimensional Aneurysm Internal medicine medicine Humans Rupture risk Bleb (cell biology) Bleb medicine.diagnostic_test business.industry Angiography Models Cardiovascular Middle Aged medicine.disease 090300 BIOMEDICAL ENGINEERING intracranial aneurysm wall shear stress eye diseases Surgery Increased risk Rotational angiography Hydrodynamics cardiovascular system Cardiology Female Stress Mechanical sense organs Neurology (clinical) Shear Strength business 110200 CARDIOVASCULAR MEDICINE AND HAEMATOLOGY |
| Zdroj: | Neurosurgery |
| ISSN: | 2381-3652 |
| Popis: | BACKGROUND: The management of unruptured aneurysms is controversial, with the decision to treat influenced by aneurysm characteristics including size and morphology. Aneurysmal bleb formation is thought to be associated with an increased risk of rupture. OBJECTIVE: To correlate computational fluid dynamic (CFD) indices with bleb formation. METHODS: Anatomic models were constructed from 3-dimensional rotational angiography data in 27 patients with cerebral aneurysms harboring a single bleb. Additional models representing the aneurysm before bleb formation were constructed by digitally removing the bleb. We characterized hemodynamic features of models both with and without the blebs using CFDs. Flow structure, wall shear stress (WSS), pressure, and oscillatory shear index (OSI) were analyzed. RESULTS: There was a statistically significant association between bleb location at or adjacent to the point of maximal WSS (74%, P = .019), irrespective of rupture status. Aneurysmal blebs were related to the inflow or outflow jet in 89% of cases (P < .001), whereas 11% were unrelated. Maximal wall pressure and OSI were not significantly related to bleb location. The bleb region attained a lower WSS after its formation in 96% of cases (P < .001) and was also lower than the average aneurysm WSS in 86% of cases (P < .001). CONCLUSION: Cerebral aneurysm blebs generally form at or adjacent to the point of maximal WSS and are aligned with major flow structures. Wall pressure and OSI do not contribute to determining bleb location. The measurement of WSS using CFD models may potentially predict bleb formation and thus improve the assessment of rupture risk in unruptured aneurysms. |
| Databáze: | OpenAIRE |
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