Hemodynamic and morphological characteristics of a growing cerebral aneurysm

作者：Mahsa Dabagh, Priya Nair, John P. Gounley, David H Frakes, L. Fernando Gonzalez, Amanda Peters Randles · 发表于：Neurosurgical FOCUS · 年份：2019 · DOI：10.3171/2019.4.focus19195 · 被引用次数：44 · 研究领域：Intracranial Aneurysms: Treatment and Complications、Vascular Malformations Diagnosis and Treatment、Aortic aneurysm repair treatments

The growth of cerebral aneurysms is linked to local hemodynamic conditions, but the driving mechanisms of the growth are poorly understood. The goal of this study was to examine the association between intraaneurysmal hemodynamic features and areas of aneurysm growth, to present the key hemodynamic parameters essential for an accurate prediction of the growth, and to gain a deeper understanding of the underlying mechanisms. Patient-specific images of a growing cerebral aneurysm in 3 different growth stages acquired over a period of 40 months were segmented and reconstructed. A unique aspect of this patient-specific case study was that while one side of the aneurysm stayed stable, the other side continued to grow. This unique case enabled the authors to examine their aims in the same patient with parent and daughter arteries under the same inlet flow conditions. Pulsatile flow in the aneurysm models was simulated using computational fluid dynamics and was validated with in vitro experiments using particle image velocimetry measurements. The authors' detailed analysis of intrasaccular hemodynamics linked the growing regions of aneurysms to flow instabilities and complex vortex structures. Extremely low velocities were observed at or around the center of the unstable vortex structure, which matched well with the growing regions of the studied cerebral aneurysm. Furthermore, the authors observed that the aneurysm wall regions with a growth greater than 0.5 mm coincided with wall ...