Patient-specific hemodynamic analysis of small internal carotid artery-ophthalmic artery aneurysms |
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| Authors: | Aichi Chien Satoshi Tateshima James Sayre Marcelo Castro Juan Cebral Fernando Viñuela |
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| Affiliation: | 1. Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;2. Department of Biostatistics, School of Public Health, University of California, Los Angeles, CA 90095, USA;3. Department of Computational Sciences, George Mason University, Fairfax, VA 22030, USA;1. Department of Neurological Surgery, University of Washington, Seattle, Washington, USA;2. Department of Pathology, University of Washington, Seattle, Washington, USA;3. Department of Neurology, University of Washington, Seattle, Washington, USA;1. Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany;2. Division of Neurosurgery, St. Michael''s Hospital, Keenan Research Centre for Biomedical Science and the Li Ka Shing Knowledge Institute of St. Michael''s Hospital, Department of Surgery, University of Toronto, Ontario, Canada;1. Department of Neurosurgery, Clinical Center of University in Sarajevo, Sarajevo, Bosnia and Herzegovina;2. Department of Neuroscience, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina;3. Semmes-Murphey Clinic and Department of Neurosurgery, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA;4. Department of Neurosurgery, Fujita Health University Center, Bantane Hospital, Nagoya, Japan;1. Department of Neurosurgery, Ludwig-Maximilians University, Campus Grosshadern, Munich, Germany;2. Department of Neuroradiology, Ludwig-Maximilians University, Campus Grosshadern, Munich, Germany |
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| Abstract: | BackgroundProphylactic treatment of unruptured small brain aneurysms is still controversial due to the low risk of rupture. Distinguishing which small aneurysms are at risk for rupture has become important for treatment. Previous studies have indicated a variety of hemodynamic properties that may influence aneurysm rupture. This study uses hemodynamic principles to evaluate these in the context of ruptured and unruptured small aneurysms in a single location.MethodsEight small internal carotid artery-ophthalmic artery (ICA-Oph) aneurysms (<10 mm) were selected from the University of California, Los Angeles, database. We analyzed rupture-related hemodynamic characteristics including flow patterns, wall shear stress (WSS), and flow impingement using previously developed patient-specific computational fluid dynamics software.ResultsMost ruptured aneurysms had complicated flow patterns in the aneurysm domes, but all of the unruptured cases showed a simple vortex. A reduction in flow velocity between the parent artery and the aneurysm sac was found in all the cases. Inside the aneurysms, the highest flow velocities were found either at the apex or neck. We also observed a trend of higher and more inhomogeneous WSS distribution within ruptured aneurysms (10.66 ± 5.99 Pa) in comparison with the unruptured ones (6.31 ± 6.47 Pa) (P < .01).ConclusionA comparison of hemodynamic properties between ruptured and unruptured small ICA-Oph aneurysms found that some hemodynamic properties vary between small aneurysms although they are similar in size and share the same anatomical location. In particular, WSS may be a useful hemodynamic factor for studying small aneurysm rupture. |
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