Effects of arterial geometry on aneurysm growth: three-dimensional computational fluid dynamics study
Effects of arterial geometry on aneurysm growth: three-dimensional computational fluid dynamics study
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DOI：
10.3171/jns.2004.101.4.0676
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发表时间：
2004-10-01
影响因子：
4.1
通讯作者：
Hopkins, LN
中科院分区：
文献类型：
--
作者：
Hoi, YM;Meng, H;Hopkins, LN
目的。很少有研究人员量化动脉几何形状在囊状脑动脉瘤发病机制中的作用。作者研究了载瘤动脉几何形状对动脉瘤血流动力学的影响，并评估了其对动脉瘤生长和治疗效果的影响。方法。使用计算流体动力学分析研究了由具有不同动脉曲线（从直血管模型开始）和颈部尺寸的动脉侧壁引起的三维囊状动脉瘤的血流动力学。量化了这些几何参数对血流动力学参数的影响，包括流速、动脉瘤壁剪切应力 (WSS) 和心动周期期间 WSS 升高的面积（时间依赖性影响区）。与涉及直动脉上的动脉瘤的模拟不同，血流惯性（离心效应）而不是粘性扩散是驱动血液进入弯曲动脉上的动脉瘤囊的主要力量。随着动脉弯曲程度的增加，颈远端的血流冲击加剧，导致WSS升高，动脉瘤颈远端冲击区扩大。结论。基于这些模拟，作者假设位于更弯曲的动脉上的外侧囊状动脉瘤承受更高的血流动力学应力。颈部较宽的囊状动脉瘤具有较大的影响区域。动脉瘤颈远端的大撞击区与其他发现有很好的相关性，表明该区域是动脉瘤生长或治疗病变再生长的最可能部位。为了防止高血流动力学压力，保护动脉瘤颈远端免受血流冲击至关重要。
Object. Few researchers have quantified the role of arterial geometry in the pathogenesis of saccular cerebral aneurysms. The authors investigated the effects of parent artery geometry on aneurysm hemodynamics and assessed the implications relative to aneurysm growth and treatment effectiveness.Methods. The hemodynamics of three-dimensional saccular aneurysms arising from the lateral wall of arteries with varying arterial curves (starting with a straight vessel model) and neck sizes were studied using a computational fluid dynamics analysis. The effects of these geometric parameters on hemodynamic parameters, including flow velocity, aneurysm wall shear stress (WSS), and area of elevated WSS during the cardiac cycle (time-dependent impact zone), were quantified. Unlike simulations involving aneurysms located on straight arteries, blood flow inertia (centrifugal effects) rather than viscous diffusion was the predominant force driving blood into aneurysm sacs on curved arteries. As the degree of arterial curvature increased, flow impingement on the distal side of the neck intensified, leading to elevations in the WSS and enlargement of the impact zone at the distal side of the aneurysm neck.Conclusions. Based on these simulations the authors postulate that lateral saccular aneurysms located on more curved arteries are subjected to higher hemodynamic stresses. Saccular aneurysms with wider necks have larger impact zones. The large impact zone at the distal side of the aneurysm neck correlates well with other findings, implicating this zone as the most likely site of aneurysm growth or regrowth of treated lesions. To protect against high hemodynamic stresses, protection of the distal side of the aneurysm neck from flow impingement is critical.