Department of Neurosurgery, The University of Tokyo, Tokyo, Japan.
Neurosurgery. 2010 Nov;67(5):1268-74; discussion 1274-5. doi: 10.1227/NEU.0b013e3181f2f442.
The development of cerebral aneurysms is related to hemodynamic stress.
To elucidate the role of shear stress in the blister formation of cerebral aneurysms.
Among 82 aneurysms detected during catheter-based 3D rotational angiography (3DRA), 4 aneurysms enlarged with blister formation during a mean follow-up period of 10.1 month. Three of these 4 aneurysms were analyzed in this study. The regions of blister formation were characterized by comparing 3DRA before and after blister formation, and computational fluid dynamic simulations were performed based on the aneurysm geometry before blister formation.
The spatially averaged shear magnitude was lower in the aneurysm region (0.97 ± 0.39 Pa) than in the parent artery (2.75 ± 0.92 Pa). The spatially averaged shear magnitude of the blister-forming area was extremely low (0.48 ± 0.12 Pa), and the shear magnitude dropped precipitately to subphysiological levels, resulting in a high shear gradient near the border of the blister-forming area.
These data suggest that low shear magnitude may trigger the progression of cerebral aneurysms and that blister formation is associated with high shear gradient in the large region of low shear magnitude on the aneurysm wall.
脑动脉瘤的发展与血流动力学有关。
阐明切应力在脑动脉瘤泡形成中的作用。
在基于导管的 3D 旋转血管造影术（3DRA）检测到的 82 个动脉瘤中，有 4 个动脉瘤在平均 10.1 个月的随访期间出现泡状扩张。本研究分析了这 4 个动脉瘤中的 3 个。通过比较泡形成前后的 3DRA 来描述泡形成区域的特征，并基于泡形成前的动脉瘤几何形状进行计算流体动力学模拟。
动脉瘤区域的空间平均剪切幅度（0.97 ± 0.39 Pa）低于母动脉（2.75 ± 0.92 Pa）。泡形成区域的空间平均剪切幅度极低（0.48 ± 0.12 Pa），剪切幅度急剧下降至亚生理水平，导致泡形成区域边界附近的剪切梯度很高。
这些数据表明，低剪切幅度可能引发脑动脉瘤的进展，而泡状形成与动脉瘤壁上大的低剪切幅度区域的高剪切梯度有关。
