Role of the bloodstream impacting force and the local pressure elevation in the rupture of cerebral aneurysms
Role of the bloodstream impacting force and the local pressure elevation in the rupture of cerebral aneurysms
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DOI：
10.1161/01.str.0000177877.88925.06
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发表时间：
2005-09-01
期刊：
影响因子：
8.3
通讯作者：
Kirino, T
中科院分区：
文献类型：
--
作者：
Shojima, M;Oshima, M;Kirino, T
背景和目的-血流的惯性力导致继发于血流冲击的局部血管内压力升高。先前的研究表明，这种“冲击力”和动脉瘤处的局部压力升高可能对脑动脉瘤的发展有很大的贡献。本研究的目的是评估血流冲击力和动脉瘤处的局部压力升高如何影响脑动脉瘤破裂。方法在26个患者特定血管模型中共创建29个动脉瘤，并利用计算机模拟计算了血管分支点和动脉瘤周围的压力分布。载瘤动脉血流的直接影响导致分支点的局部压力升高和动脉弯曲（231.2 +/- 198.1 Pa; 100 Pa=0.75 mm Hg）。血流撞击动脉瘤分支点或弯曲处后进入动脉瘤的速度减慢。因此，动脉瘤处的流动冲击通常较弱。在动脉瘤的顶部或破裂点，血流速度总是延迟的。动脉瘤处的局部压力升高为119.3 +/- 91.2 Pa。结论-血流影响区域和动脉瘤处的压力升高仅占峰值血管内压力的1%至2%。结果表明，血流冲击力和动脉瘤局部压力升高对脑动脉瘤破裂的贡献可能比以前预期的要小。
Background and Purpose - Inertial force of the bloodstream results in the local elevation of intravascular pressure secondary to flow impact. Previous studies suggest that this "impacting force" and the local pressure elevation at the aneurysm may have a large contribution to the development of cerebral aneurysms. The goal of the present study is to evaluate how the bloodstream impacting force and the local pressure elevation at the aneurysm influences the rupture of cerebral aneurysms.Methods - A total of 29 aneurysms were created in 26 patient-specific vessel models, and computer simulations were used to calculate pressure distributions around the vessel branching points and the aneurysms.Results - Direct impact of the parent artery bloodstream resulted in local elevation in pressure at branch points, and bends in arteries (231.2 +/- 198.1 Pa; 100 Pa=0.75 mm Hg). The bloodstream entered into the aneurysm with a decreased velocity after it impacted on the branching points or bends. Thus, the flow impact at the aneurysm occurred usually weakly. At the top or the rupture point of the aneurysm, the flow velocity was always delayed. The local pressure elevation at the aneurysm was 119.3 +/- 91.2 Pa.Conclusions - The pressure elevation at the area of flow impact and at the aneurysm constituted only 1% to 2% of the peak intravascular pressure. The results suggest that the bloodstream impacting force and the local pressure elevation at the aneurysm may have less contribution to the rupture of cerebral aneurysms than was expected previously.