基底动脉干梭形动脉瘤的不同治疗模式：计算流体力学研究

背景　通过改变血流动力学状态可以治疗不可夹闭的基底动脉干梭形动脉瘤。本研究应用计算流体力学的方法建立基底动脉干梭形动脉瘤计算机模型并研究其血流动力学特征。方法　用MIMICS、ANSYS和CFX软件建立基底动脉干动脉瘤三维数字化模型。将模型设置不同的血流动力学模式和边界条件，在动脉瘤内和动脉瘤壁上分别随机选取30个坐标点，计算坐标点血液流速，壁压力和壁剪切力，分析不同模式下相关的力学参数特征，比较不同模式之间的血流动力学差异。结果 分别计算30个坐标点壁剪切力，壁压力和血流速度的均值并进行比较，模型A和模型B动脉瘤内血流速度和动脉瘤壁剪切力较其他模型高，模型A、E和F的动脉瘤壁压力高于其它模型。结论 基底动脉干动脉瘤血流动力学模型可靠、实用，可以为基底动脉瘤临床治疗方案的选择提供重要的参考信息；通过改变基底动脉瘤血流动力学状态，不可夹闭的梭形基底动脉干动脉瘤可以得到有效的治疗。对于梭形基底动脉瘤，阻断双侧椎动脉要非常慎重，要在后交通动脉的侧枝循环或有效的高流量架桥血流保证基底动脉穿通支有一定灌注压情况下进行。

Different treatment modalities of a fusiform basilar trunk aneurysm: a study of computational hemodynamic characteristics

Background Unclippable fusiform basilar trunk aneurysm is a formidable condition for surgical treatment. The aim of the study is to establish a computational model and investigate the hemodynamic characteristic in a fusiform basilar trunk aneurysm. Methods The three-dimensional digital model of a fusiform basilar trunk aneurysm was constructed using MIMICS, ANSYS and CFX software. Different hemodynamic modalities and border conditions were assigned to the model. Thirty points were selected randomly on the wall and within the aneurysm. Wall total pressure (WTP), wall shear stress (WSS), and blood flow velocity of each point were calculated and hemodynamic status was compared between different modalities. Results The quantitative average values of the 30 points on the wall and within the aneurysm were obtained by computational calculation point by point. The velocity and WSS in Mod A and B is different from those of the remaining 5 modalities and the WTP in Mod A, E and F is higher than those of the remaining 4 modalities. Conclusion The digital model of a fusiform basilar artery aneurysm is feasible and reliable. This model could provide some important information to clinical treatment options. By changing the hemodynamic status, the unclippable fusiform basilar artery aneurysm could be treated effectively.