Curvature effect on hemodynamic conditions at the inner bend of the carotid siphon and its relation to aneurysm formation.
Curvature effect on hemodynamic conditions at the inner bend of the carotid siphon and its relation to aneurysm formation.
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DOI：
10.1016/j.jbiomech.2014.06.042
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发表时间：
2014-09-22
影响因子：
2.4
通讯作者：
Malek, Adel M.
中科院分区：
文献类型：
--
作者：
Lauric, Alexandra;Hippelheuser, James;Safain, Mina G.;Malek, Adel M.
虽然高冲击血流动力学力被认为会导致脑动脉瘤的变化，但对血管弯曲（如颈内动脉（伊卡）虹吸管）内部的动脉瘤形成知之甚少，其中壁切应力（WSS）预计较低。本研究评价血管曲率和血流动力学对沿着颈内动脉虹吸部动脉瘤形成的影响。在3D中评价了35例伊卡（10例动脉瘤，25例对照）的导管3D旋转血管造影体积的虹吸管弯曲曲率半径和峰值曲率，随后进行单变量统计分析。对动脉瘤切除后的患者衍生模型和曲率增加的合成变体进行计算流体动力学（CFD）模拟。承载ICA的动脉瘤的峰值局灶虹吸曲率显著更高（0.36±0.045 vs. 0.30±0.048 mm−1，p=0.003），整体曲率半径无差异（p=0.36）。在CFD模拟中，增加参数曲率紧密度（半径从5 mm增加到3 mm）导致弯曲内壁上的WSS和WSS梯度幅度（WSSG）显著增加。在患者数据中，动脉瘤的位置与两侧为高WSS和WSSG峰的低WSS（<4 Pa）区域一致。WSS峰值与动脉瘤颈相关。相比之下，对照虹吸管弯曲显示出低的、几乎恒定的WSS和WSSG剖面，空间变化很小。高弯曲曲率诱导动态波动的高近端WSS和WSSG，随后是血流停滞和再循环区域，导致已知可诱导破坏性血管壁重塑和血管瘤启动的局部条件。
Although high-impact hemodynamic forces are thought to lead to cerebral aneurysmal change, little is known about the aneurysm formation on the inner aspect of vascular bends such as the internal carotid artery (ICA) siphon where wall shear stress (WSS) is expected to be low. This study evaluates the effect of vessel curvature and hemodynamics on aneurysm formation along the inner carotid siphon. Catheter 3D-rotational angiographic volumes of 35 ICA (10 aneurysms, 25 controls) were evaluated in 3D for radius of curvature and peak curvature of the siphon bend, followed by univariate statistical analysis. Computational fluid dynamic (CFD) simulations were performed on patient-derived models after aneurysm removal and on synthetic variants of increasing curvature. Peak focal siphon curvature was significantly higher in aneurysm bearing ICAs (0.36±0.045 vs. 0.30±0.048 mm−1, p=0.003), with no difference in global radius of curvature (p=0.36). In CFD simulations, increasing parametric curvature tightness (from 5 to 3 mm radius) resulted in dramatic increase of WSS and WSS gradient magnitude (WSSG) on the inner wall of the bend. In patient-derived data, the location of aneurysms coincided with regions of low WSS (<4 Pa) flanked by high WSS and WSSG peaks. WSS peaks correlated with the aneurysm neck. In contrast, control siphon bends displayed low, almost constant, WSS and WSSG profiles with little spatial variation. High bend curvature induces dynamically fluctuating high proximal WSS and WSSG followed by regions of flow stasis and recirculation, leading to local conditions known to induce destructive vessel wall remodeling and aneurysmal initiation.
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影响因子：
8.3
作者：
Metaxa E;Tremmel M;Natarajan SK;Xiang J;Paluch RA;Mandelbaum M;Siddiqui AH;Kolega J;Mocco J;Meng H
通讯作者：
Meng H
影响因子：
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影响因子：
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作者：
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通讯作者：
Malek, Adel M.
影响因子：
4.8
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通讯作者：
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