Kim C, Cervós-Navarro J, Pätzold C, Tokuriki Y, Takebe Y, Hori K
Institute of Neuropathology, Free University of Berlin, Federal Republic of Germany.
Acta Neurochir (Wien). 1992;115(3-4):112-7. doi: 10.1007/BF01406368.
In order to investigate the developmental mechanism of cerebral aneurysms, the in vivo flow pattern around human cervical carotid bifurcations was studied by flow visualization using digital subtraction angiography with an isotonic contrast medium. The blood stream containing the medium impinged on the apex, then proceeded along the walls of the branches. After opacification of the whole lumen around the apex, most of the medium was carried away, while some remained for a few seconds at the carotid sinus. In the internal carotid artery, the blood struck the wall at an oblique angle near the tops of the arterial curvatures. In cases with atheromatous plaque or kinking of the branch, the blood passed through the stenosed segment and moved upstream, indicating turbulence. The study suggests that haemodynamic forces around the apex consist mainly of impingement on the apex and shear stress to the wall at and around the apex. In branches, high shear stress seems to exist. It might be possible that high shear stress causes degenerative changes in the endothelial layer, initiating the formation of saccular and fusiform cerebral aneurysms.
为了研究脑动脉瘤的发育机制，我们使用等渗造影剂通过数字减影血管造影术进行血流可视化，对人体颈总动脉分叉周围的体内血流模式进行了研究。含有造影剂的血流冲击到顶点，然后沿着分支的壁流动。在顶点周围的整个管腔显影后，大部分造影剂被冲走，而一些在颈动脉窦停留了几秒钟。在颈内动脉中，血液在动脉弯曲顶部附近以斜角撞击血管壁。在存在动脉粥样硬化斑块或分支扭结的情况下，血液通过狭窄段并向上游流动，表明存在湍流。该研究表明，顶点周围的血流动力学力主要包括对顶点的冲击以及顶点处和顶点周围血管壁的剪切应力。在分支中，似乎存在高剪切应力。高剪切应力可能导致内皮细胞层发生退行性变化，从而引发囊状和梭形脑动脉瘤的形成。
