Local Hemodynamic Conditions Associated with Focal Changes in the Intracranial Aneurysm Wall.

作者：Juan Raul Cebral, Felicitas J. Detmer, Bong Jae Chung, Joham Choque‐Velasquez, Banafsheh Rezai, Hanna Lehto, Riikka M. Tulamo, Juha Antero Hernesniemi, Mika R. Niemela, Alexander Kwong-Tak Yu, Richard Williamson, Khaled M. Abdel Aziz, S Shakur, Sepideh Amin‐Hanjani, Fady T. Charbel, Yasutaka Tobe, Anne M. Robertson, Juhana Frösén · 发表于：PubMed · 年份：2019 · DOI：10.3174/ajnr.a5970 · 被引用次数：95 · 研究领域：Intracranial Aneurysms: Treatment and Complications、Aortic aneurysm repair treatments、Coronary Interventions and Diagnostics

BACKGROUND AND PURPOSE: Aneurysm hemodynamics has been associated with wall histology and inflammation. We investigated associations between local hemodynamics and focal wall changes visible intraoperatively. MATERIALS AND METHODS: Computational fluid dynamics models were constructed from 3D images of 65 aneurysms treated surgically. Aneurysm regions with different visual appearances were identified in intraoperative videos: 1) "atherosclerotic" (yellow), 2) "hyperplastic" (white), 3) "thin" (red), 4) rupture site, and 5) "normal" (similar to parent artery), They were marked on 3D reconstructions. Regional hemodynamics was characterized by the following: wall shear stress, oscillatory shear index, relative residence time, wall shear stress gradient and divergence, gradient oscillatory number, and dynamic pressure; these were compared using the Mann-Whitney test. RESULTS: = .009) than hyperplastic regions. Thin regions tended to be aligned with the flow stream, while atherosclerotic and hyperplastic regions tended to be aligned with recirculation zones. CONCLUSIONS: Local hemodynamics is associated with visible focal wall changes. Slow swirling flow with low and oscillatory wall shear stress was associated with atherosclerotic and hyperplastic changes. High flow conditions prevalent in regions near the flow impingement site characterized by higher and less oscillatory wall shear stress were associated with local "thinning" of the wall.