Madrazo I, Noyola A, Piña C, Graef A, Olhagaray M, Gutiérrez S, Ordóñez E
Departamento de Neurocirugía, Hospital de Especialidades, Centro Médico La Raza, IMSS, México.
Arch Invest Med (Mex). 1990 Apr-Jun;21(2):103-13.
We wish to confirm the hypothesis that the hydrodynamics of brain aneurysms depend partially on their position, with respect to the force of gravitation, and so developed an experimental model of latex aneurysms, which was subjected to a pulsatile flow. Four different registers were made with an injection of ink and radioisotopes. A physical model was designed which allowed a quantitative analysis of the results and which allows a mathematical analysis of the aneurysm's hydrodynamics. The results suggest that when an aneurysm is oriented against the force of gravity, it has a very low risk of thrombosis, and the scarce turbulence of the flow condition a lower risk of growth and rupture, in comparison with other conditions. The greatest flow turbulence against the wall is found in the aneurysm oriented downwards, that is parallel to the force of gravity. Due to its hydrodynamics, the downwards aneurysm has the highest probability of complication, since it has; a) higher risk of rupture due to the impact of the stream upon the wall and to the turbulence this impact produces, b) a higher risk of thrombosis produced by the circulatory stasis which has a dome. This combination of factors (rupture and thrombosis) allows these aneurysms to grow more than others.
我们希望证实这样一个假设，即脑动脉瘤的流体动力学部分取决于其相对于重力的位置，因此我们建立了一个乳胶动脉瘤实验模型，并对其施加脉动血流。通过注入墨水和放射性同位素进行了四种不同的记录。设计了一个物理模型，该模型可以对结果进行定量分析，并能对动脉瘤的流体动力学进行数学分析。结果表明，当动脉瘤与重力方向相反时，其血栓形成风险非常低，与其他情况相比，血流条件下的微弱湍流使生长和破裂风险降低。在与重力平行向下的动脉瘤中，发现其对壁的血流湍流最大。由于其流体动力学特性，向下的动脉瘤发生并发症的可能性最高，因为它：a）由于血流对壁的冲击以及这种冲击产生的湍流，破裂风险更高；b）由具有穹顶的循环淤滞产生的血栓形成风险更高。这些因素（破裂和血栓形成）的综合作用使得这些动脉瘤比其他动脉瘤生长得更多。
