ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2022
Hemodynamic factor evaluation using computational fluid dynamics analysis for de novo bleb formation in unruptured intracranial aneurysms.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough bleb formation increases the risk of rupture of intracranial aneurysms, previous computational fluid dynamic (CFD) studies have been unable to identify robust causative hemodynamic factors, due to the morphological differences of prebleb aneurysm models and a small number of aneurysms with de novo bleb formation. This study investigated the influences of differences in the aneurysm-models and identify causative hemodynamic factors for de novo bleb formation. MATERIALS AND
methodsCFD analysis was conducted on three aneurysm models, actual prebleb, postbleb, and virtual prebleb models of two unruptured aneurysms with de novo bleb formation. A new multipoint method was introduced in this study. We evenly distributed points with a 0.5-mm distance on the aneurysm surface of the actual prebleb models (146 and 152 points in the individual aneurysm, respectively), and we statistically compared hemodynamics at the points in the areas with and without bleb formation (19 and 279 points, respectively).
resultsVisually, blebs formed on an aneurysm surface area with similar hemodynamic characteristics in the actual and virtual prebleb models. Statistical analysis using the multipoint method revealed that the de novo bleb formation area was significantly correlated with high pressure (p < 0.001), low wall shear stress (WSS) (p < 0.001), and the center of divergent WSS vectors (p = 0.025).
conclusionsDe novo bleb formation in intracranial aneurysms may occur in areas associated with the combination of high pressure, low WSS, and the center of divergent WSS vectors. The multipoint method is useful for statistical analysis of hemodynamics in a limited number of aneurysms.
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