Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture.
Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture.
复制标题
前交通动脉瘤的血液动力学模式：可能与破裂的关联。
DOI：
10.3174/ajnr.a1323
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发表时间：
2009-02
期刊：
影响因子：
--
通讯作者：
Cebral JR
中科院分区：
文献类型：
--
作者：
Castro MA;Putman CM;Sheridan MJ;Cebral JR
The purpose of this study is to characterize the different flow types present at anterior communicating artery aneurysms and investigate possible associations with rupture. Patient-specific computational models of 26 anterior communicating artery aneurysms were constructed from 3D rotational angiography images. Bilateral images were acquired in 15 patients who had both A1 segments of the anterior cerebral arteries and models of the whole anterior circulation were created by fusing the reconstructed left and right arterial trees. Computational fluid dynamics simulations were performed under pulsatile flow conditions measured on a healthy subject. Visualizations of flow velocity, instantaneous streamlines, and wall shear stress were performed. These were analyzed for flow patterns, size of the impaction zone, and peak wall shear stress (WSS) and then correlations made with prior history of rupture. Aneurysms with small impaction zones were more likely to have ruptured than those with large impaction zones (83% vs. 63%). Maximum intra-aneurysmal WSS (MWSS) for the unruptured aneurysms ranged from 10 to 230 dyn/cm2 (mean 114 dyn/cm2) compared with ruptured aneurysms from 35–1500 dyn/cm2 (mean 271 dyn/cm2). This difference in MWSS was statistically significant at 90% confidence levels (p=0.10). Aneurysms with small impaction zones, higher flow rates entering the aneurysm, and elevated maximum wall shear stress are associated with a clinical history of previous rupture.
