Angular Remodeling in Single Stent-Assisted Coiling Displaces and Attenuates the Flow Impingement Zone at the Neck of Intracranial Bifurcation Aneurysms

Neurosurgery ◽  
2013 ◽  
Vol 72 (5) ◽  
pp. 739-748 ◽  
Author(s):  
Bulang Gao ◽  
Merih I. Baharoglu ◽  
Adel M. Malek
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Computational Fluid Dynamic ◽  
Fluid Dynamic ◽  
Bifurcation Angle ◽  
Impingement Zone ◽  
Wall Shear ◽  
And Migration ◽  
The Impact

Abstract BACKGROUND: Self-expanding intracranial stent-assisted coiling of bifurcation aneurysms has recently been shown to straighten target cerebral vessels, a phenomenon with unknown hemodynamic effect. OBJECTIVE: To investigate the impact of angular remodeling in aneurysms treated with single stent-assisted coiling with the use of computational fluid dynamic techniques. METHODS: Fourteen patients (7 women, mean age 55) who underwent stent coiling of 14 wide-necked bifurcation aneurysms were included based on the availability of high-resolution 3-dimensional rotational angiography. Pretreatment data sets underwent virtual aneurysm removal to isolate the effect of stenting. Wall shear stress and pressure profiles obtained from constant flow input computational fluid dynamic analysis were analyzed for apical hemodynamic changes. RESULTS: Stenting increased the bifurcation angle with significant straightening immediately after treatment and at follow-up (107.3° vs 144.9°, P < .001). The increased stented angle at follow-up led to decreased pressure drop at the bifurcation apex (12.2 vs 9.9 Pa, P < .003) and migration of the flow impingement zone (FIZ) toward the contralateral nonstented daughter branch by a mean of 1.48 ± 0.2 mm. Stent-induced angular remodeling decreased FIZ width separating peak apical wall shear stress (3.4 vs 2.5 mm, P < .004). Analysis of FIZ distance measured from the parent vessel centerline showed it to be linearly (r = .58, P < .002) and FIZ width inversely correlated (r = .46, P < .02) to vessel bifurcation angle. CONCLUSION: Stent-induced angular remodeling significantly altered bifurcation apex hemodynamics in a favorable direction by blunting apical pressure and inducing the narrowing and migration of the FIZ, a novel response to intracranial stenting that should be added to intimal hyperplasia and flow diversion.

Computational fluid dynamic-derived wall shear stress of non-significant left main bifurcation disease may predict acute vessel thrombosis at 3-year follow-up

2019 ◽  
Vol 35 (3) ◽  
pp. 297-306 ◽  
Author(s):  
Marco Zuin ◽  
Gianluca Rigatelli ◽  
Dobrin Vassilev ◽  
Federico Ronco ◽  
Alberto Rigatelli ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Computational Fluid Dynamic ◽  
Fluid Dynamic ◽  
Left Main ◽  
Wall Shear ◽  
Vessel Thrombosis

Analysis of Flow and Wall Shear Stress in Curvature Induced Dorsal Aneurysms: Effect of Arterial Curvature

2009 ◽  
Author(s):  
Arun Ramu ◽  
Guo-Xiang Wang
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Fluid Dynamic ◽  
Cerebral Arteries ◽  
Cerebral Aneurysms ◽  
Morbidity Rate ◽  
Mortality And Morbidity ◽  
Wall Shear ◽  
Primary Velocity ◽  
The Impact

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.

Computational fluid dynamic measures of wall shear stress are related to coronary lesion characteristics

Heart ◽  
2016 ◽  
Vol 102 (20) ◽  
pp. 1655-1661 ◽  
Author(s):  
Jun-Bean Park ◽  
Gilwoo Choi ◽  
Eun Ju Chun ◽  
Hyun Jin Kim ◽  
Jonghanne Park ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Computational Fluid Dynamic ◽  
Fluid Dynamic ◽  
Coronary Lesion ◽  
Wall Shear ◽  
Dynamic Measures

scholarly journals Computational Fluid Dynamic Simulations of Maternal Circulation: Wall Shear Stress in the Human Placenta and Its Biological Implications

PLoS ONE ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. e0147262 ◽  
Author(s):  
E. Lecarpentier ◽  
M. Bhatt ◽  
G. I. Bertin ◽  
B. Deloison ◽  
L. J. Salomon ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Computational Fluid Dynamic ◽  
Human Placenta ◽  
Fluid Dynamic ◽  
Maternal Circulation ◽  
Dynamic Simulations ◽  
Wall Shear

P 1 Computational fluid dynamic simulations of maternal circulation – Wall shear stress in the human placenta and its biological implications

2017 ◽  
Vol 9 ◽  
pp. 36-37
Author(s):  
Edouard Lecarpentier ◽  
Mrugank Bhatt ◽  
Gwladys Bertin ◽  
Benjamin Deloison ◽  
Laurent Salomon ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Computational Fluid Dynamic ◽  
Human Placenta ◽  
Fluid Dynamic ◽  
Maternal Circulation ◽  
Dynamic Simulations ◽  
Wall Shear

scholarly journals High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972199172
Author(s):  
Artan Bajraktari ◽  
Ibadete Bytyçi ◽  
Michael Y. Henein
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Plaque Vulnerability ◽  
Coronary Wall ◽  
Wall Shear ◽  
The Impact

Aim: The aim of this meta-analysis is to assess the impact of wall shear stress (WSS) severity on arterial plaque vulnerability. Methods: We systematically searched electronic databases and selected studies which assessed the relationship between WSS measured by intravascular ultrasound and coronary artery plaque features. In 7 studies, a total of 615 patients with 28 276 arterial segments (median follow-up: 7.71 months) were identified. At follow-up, the pooled analysis showed high WSS to be associated with regression of plaque fibrous area, weighted mean difference (WMD) −0.11 (95% CI: −0.20 to −0.02, P = .02) and fibrofatty area, WMD −0.09 (95% CI: −0.17 to −0.01, P = .02), reduction in plaque total area, WMD −0.09 (95% CI: −0.14 to −0.04, P = .007) and increased necrotic core area, and WMD 0.04 (95% CI: 0.01-0.09, P = .03) compared with low WSS. Dense calcium deposits remained unchanged in high and low WSS (0.01 vs 0.02 mm2; P > .05). High WSS resulted in profound remodeling (40% vs 18%, P < .05) and with more constructive remodeling than low WSS (78% vs 40%, P < .01). Conclusions: High WSS in coronary arteries is associated with worsening plaque vulnerability and more profound arterial wall remodeling compared with low WSS.

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