Liu Yongsheng, Jiang Guinan, Wang Feng, An Xiangbo
Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Neurol. 2021 Apr 29;12:632066. doi: 10.3389/fneur.2021.632066. eCollection 2021.
It was speculated that the alteration of the geometry of the artery might lead to hemodynamic changes of distal arteries. This study was to investigate the hemodynamic changes of distal arterial trees, and to identify the factors accounting for hyperperfusion after the obliteration of large intracranial aneurysms. We retrospectively reviewed data of 12 patients with intracranial carotid aneurysms. Parametric models with intracranial carotid aneurysm were created. Patient-specific geometries were generated by three-dimensional rotational angiography. To mimic the arterial geometries after complete obliteration of the aneurysms, the aneurysms were virtually removed. The Navier-Stokes equations were solved using ANSYS CFX 14. The average wall shear stress, pressure and flow velocity were measured. Pressure ratio values were significantly higher in A1 segments, M1 segments, and M2 + M3 segments after obliteration of the aneurysms ( = 0.048 in A1 segments, = 0.017 in M1 segments, = 0.001 in M2 + M3 segments). Velocity ratio values were significantly higher in M1 segments and M2 + M3 segments after obliteration of the aneurysms ( = 0.047 in M1 segments, = 0.046 in M2 + M3 segments). The percentage of pressure ratio increase after obliteration of aneurysms was significantly correlated with aneurysmal angle ( = 0.739, = 0.006 for M2 + M3). The pressure and flow velocity of distal arterial trees became higher after obliteration of aneurysms. The angle between the aneurysm and the parent artery was the factor accounting for pressure increase after treatment.
据推测，动脉几何形状的改变可能会导致远端动脉的血流动力学变化。本研究旨在调查远端动脉树的血流动力学变化，并确定大型颅内动脉瘤闭塞后导致高灌注的因素。我们回顾性分析了12例颅内颈动脉瘤患者的数据。建立了带有颅内颈动脉瘤的参数模型。通过三维旋转血管造影生成患者特异性的几何形状。为了模拟动脉瘤完全闭塞后的动脉几何形状，将动脉瘤虚拟移除。使用ANSYS CFX 14求解纳维-斯托克斯方程。测量平均壁面剪应力、压力和流速。动脉瘤闭塞后，A1段、M1段和M2 + M3段的压力比值显著升高（A1段P = 0.048，M1段P = 0.017，M2 + M3段P = 0.001）。动脉瘤闭塞后，M1段和M2 + M3段的速度比值显著升高（M1段P = 0.047，M2 + M3段P = 0.046）。动脉瘤闭塞后压力比值增加的百分比与动脉瘤角度显著相关（M2 + M3段r = 0.739，P = 0.006）。动脉瘤闭塞后，远端动脉树的压力和流速升高。动脉瘤与母动脉之间的角度是治疗后压力升高的因素。
