Abstract WP83: Wall Shear Stress Strength Over the Cerebral Aneurysm is Drastically Affected by Aneurysm Location While the Magnitude of Disturbed Flow is Closely Related to Aneurysm Size and Surface Area

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Shunichi Fukuda ◽  
Yuji Shimogonya

Background and purpose: The rupture rate of cerebral aneurysms varies according to the aneurysm size and location. Although several reports suggest hemodynamic involvement in the mechanisms, there still remains to be clarified. Using computational fluid dynamics, we elucidated here differences in hemodynamics according to size and location of human cerebral aneurysms. Methods: Patient-specific inflow velocities and arterial geometries of 39 MCA aneurysms and anterior communicating artery (Acom) aneurysms were acquired from patients who consented to participate in the multi-institutional prospective clinical study, CFD ABO Study. Pulsatile blood flow was simulated using ANSYS-CFX, based on the Navier-Stokes equations for incompressible fluid. Aneurysms were divided into 3 groups by their size; less than 5mm, less than 7mm and more than 5mm, and more than 7mm. Results: Wall shear stress (WSS) was significantly lower in Acom aneurysms than MCA aneurysms (p=0.00075) while there was no significant difference in WSS according to aneurysm size. In contrast, indicators for disturbed flow, oscillatory shear index (OSI) and normalized transverse WSS (NtransWSS) were significantly higher over the aneurysms of the size less than 7mm and more than 5mm compared to those less than 5mm (p=0.021 and 0.014, respectively). Moreover, there were strong or moderate positive correlations between aneurysm surface area and OSI and NtransWSS, but not WSS. However, there was no significant difference in OSI or NtransWSS between MCA and Acom aneurysms. Conclusions: The data suggest that WSS strength over the cerebral aneurysm is drastically affected by the aneurysm location while the magnitude of disturbed flow is closely related to aneurysm size and surface area. A significant lower WSS in Acom aneurysms compared to MCA aneurysms may be associated with higher rupture rate in Acom aneurysms. In contrast, disturbed flow may be involved in aneurysm enlargement.

2012 ◽  
Vol 134 (9) ◽  
Author(s):  
Matthew D. Ford ◽  
Ugo Piomelli

Cerebral aneurysms are a common cause of death and disability. Of all the cardiovascular diseases, aneurysms are perhaps the most strongly linked with the local fluid mechanic environment. Aside from early in vivo clinical work that hinted at the possibility of high-frequency intra-aneurysmal velocity oscillations, flow in cerebral aneurysms is most often assumed to be laminar. This work investigates, through the use of numerical simulations, the potential for disturbed flow to exist in the terminal aneurysm of the basilar bifurcation. The nature of the disturbed flow is explored using a series of four idealized basilar tip models, and the results supported by four patient specific terminal basilar tip aneurysms. All four idealized models demonstrated instability in the inflow jet through high frequency fluctuations in the velocity and the pressure at approximately 120 Hz. The instability arises through a breakdown of the inflow jet, which begins to oscillate upon entering the aneurysm. The wall shear stress undergoes similar high-frequency oscillations in both magnitude and direction. The neck and dome regions of the aneurysm present 180 deg changes in the direction of the wall shear stress, due to the formation of small recirculation zones near the shear layer of the jet (at the frequency of the inflow jet oscillation) and the oscillation of the impingement zone on the dome of the aneurysm, respectively. Similar results were observed in the patient-specific models, which showed high frequency fluctuations at approximately 112 Hz in two of the four models and oscillations in the magnitude and direction of the wall shear stress. These results demonstrate that there is potential for disturbed laminar unsteady flow in the terminal aneurysm of the basilar bifurcation. The instabilities appear similar to the first instability mode of a free round jet.


2019 ◽  
Vol 11 (10) ◽  
pp. 999-1003 ◽  
Author(s):  
Michael R Levitt ◽  
Christian Mandrycky ◽  
Ashley Abel ◽  
Cory M Kelly ◽  
Samuel Levy ◽  
...  

ObjectivesTo study the correlation between wall shear stress and endothelial cell expression in a patient-specific, three-dimensional (3D)-printed model of a cerebral aneurysm.Materials and methodsA 3D-printed model of a cerebral aneurysm was created from a patient’s angiogram. After populating the model with human endothelial cells, it was exposed to media under flow for 24 hours. Endothelial cell morphology was characterized in five regions of the 3D-printed model using confocal microscopy. Endothelial cells were then harvested from distinct regions of the 3D-printed model for mRNA collection and gene analysis via quantitative polymerase chain reaction (qPCR.) Cell morphology and mRNA measurement were correlated with computational fluid dynamics simulations.ResultsThe model was successfully populated with endothelial cells, which survived under flow for 24 hours. Endothelial morphology showed alignment with flow in the proximal and distal parent vessel and aneurysm neck, but disorganization in the aneurysm dome. Genetic analysis of endothelial mRNA expression in the aneurysm dome and distal parent vessel was compared with the proximal parent vessels. ADAMTS-1 and NOS3 were downregulated in the aneurysm dome, while GJA4 was upregulated in the distal parent vessel. Disorganized morphology and decreased ADAMTS-1 and NOS3 expression correlated with areas of substantially lower wall shear stress and wall shear stress gradient in computational fluid dynamics simulations.ConclusionsCreating 3D-printed models of patient-specific cerebral aneurysms populated with human endothelial cells is feasible. Analysis of these cells after exposure to flow demonstrates differences in both cell morphology and genetic expression, which correlate with areas of differential hemodynamic stress.


2016 ◽  
Vol 24 (3) ◽  
pp. 349-357 ◽  
Author(s):  
Lijian Xu ◽  
Michiko Sugawara ◽  
Gaku Tanaka ◽  
Makoto Ohta ◽  
Hao Liu ◽  
...  

2016 ◽  
Vol 16 (1) ◽  
pp. 97-115 ◽  
Author(s):  
A. J. Geers ◽  
H. G. Morales ◽  
I. Larrabide ◽  
C. Butakoff ◽  
P. Bijlenga ◽  
...  

Author(s):  
Arun Ramu ◽  
Guo-Xiang Wang

Intracranial aneurysms are abnormal enlargement in the walls of cerebral arteries. The rupture of aneurysms is the leading cause of subarachnoid hemorrhage (SAH), with a high mortality and morbidity rate. A majority of saccular cerebral aneurysms occur at sites of arterial bifurcations. However, a good percentage of aneurysms are curvature induced and are found along the cavernous arterial segment. The occurrence of such non branching aneurysms, clinically called dorsal aneurysms, can be related to the increased wall shear stress at the curved arteries. The rupture of aneurysms usually occurs at the dome region, which is subjected to reduced wall shear stress (wss) owing to low re-circulating flow. Hence it is important to understand the impact of arterial curvature on the WSS distribution along the dome of aneurysms. Previously, studies have not taken into account the aspect of low WSS along the dome region. In the present 3-d computational fluid dynamic approach, we investigate the impact of varying arterial curvature on spherical dorsal aneurysms. The primary velocity patterns, the WSS distribution along the dome of the aneurysm and the area of increased WSS have been quantified for steady flow conditions.


Author(s):  
Jennifer Dolan ◽  
Song Liu ◽  
Hui Meng ◽  
John Kolega

In both human and animal models, cerebral aneurysms tend to develop at the apices of bifurcations in the cerebral vasculature. Due to the focal nature of aneurysm development it has long been speculated that hemodynamics are an important factor in aneurysm susceptibility. The local hemodynamics of bifurcations are complex, being characterized by flow impingement causing a high frictional force on the vessel wall known as wall shear stress (WSS) and significant flow acceleration or deceleration, manifested as the positive or negative spatial gradient of WSS (WSSG). In vivo studies have recently identified that aneurysm initiation occurs at areas of the vessel wall that experience a combination of both high WSS and positive WSSG [1,2]


2011 ◽  
Vol 32 (3) ◽  
pp. 587-594 ◽  
Author(s):  
Z. Kulcsár ◽  
Á. Ugron ◽  
M. Marosfői ◽  
Z. Berentei ◽  
G. Paál ◽  
...  

Author(s):  
Jennifer Dolan ◽  
Frasier Sim ◽  
Hui Meng ◽  
John Kolega

In both human and animal models, cerebral aneurysms tend to develop at the apices of bifurcations in the cerebral vasculature where the blood vessel wall experiences complex hemodynamics. In vivo studies have recently revealed that the initiation of cerebral aneurysms is confined to a well-defined hemodynamic microenvironment [1,2]. Metaxa et al. [2] found that early aneurysm remodeling initiates where the vessel wall experiences high wall shear stress (WSS) and flow is accelerating, thus creating a positive spatial gradient in WSS (WSSG). Closer examination of such in vivo studies reveals that exposure of the vessel wall to equally high WSS in the presence of decelerating flow, that is, negative WSSG, does not result in aneurysm-like destruction.


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