Department of Medical Research and Neurosurgery, Shijiazhuang People's Hospital, 9 Fangbei Road, Shijiazhuang, 050011, Hebei, China.
Department of Laboratory Analysis, Zhengzhou University First Affiliated Hospital, Zhengzhou, China.
Sci Rep. 2022 Mar 24;12(1):5106. doi: 10.1038/s41598-022-09000-7.
Currently, the relationship of bifurcation morphology and aneurysm presence at the major cerebral bifurcations is not clear. This study was to investigate cerebral arterial bifurcation morphology and accompanied hemodynamic stresses associated with cerebral aneurysm presence at major cerebral arterial bifurcations. Cerebral angiographic data of major cerebral artery bifurcations of 554 anterior cerebral arteries, 582 internal carotid arteries, 793 middle cerebral arteries and 195 basilar arteries were used for measurement of arterial diameter, lateral and bifurcation angles and aneurysm deviation. Hemodynamic stresses were analyzed using computational fluid dynamic simulation. Significantly (P < 0.001) more aneurysms deviated toward the smaller branch and the smaller lateral angle than towards the larger branch and larger lateral angle at all four major bifurcations. At the flow direct impinging center, the total pressure was the greatest while the dynamic pressure, wall shear stress (WSS), vorticity and strain rate were the least. Peak 1 and Peak 2 were located on the branch forming a smaller and larger angle with the parent artery, respectively. The dynamic pressure (175.4 ± 18.6 vs. 89.9 ± 7.6 Pa), WSS (28.9 ± 7.4 vs. 15.7 ± 5.3 Pa), vorticity (9874.6 ± 973.4 vs. 7237.8 ± 372.7 1/S), strain rate (9873.1 ± 625.6 vs. 7648.3 ± 472.5 1/S) and distance (1.9 ± 0.8 vs. 1.3 ± 0.3 mm) between the peak site and direct flow impinging center were significantly greater at Peak 1 than at Peak 2 (P < 0.05 or P < 0.01). Moreover, aneurysms deviation and Peak 1 were always on the same side. In conclusion, the branch forming a smaller angle with the parent artery is associated with abnormally enhanced hemodynamic stresses to initiate an aneurysm at the bifurcation apex.
目前，大脑主要动脉分叉处的分叉形态与动脉瘤的存在之间的关系尚不清楚。本研究旨在探讨大脑动脉分叉形态与大脑主要动脉分叉处动脉瘤存在相关的伴随血流动力学应力。对 554 条前交通动脉、582 条颈内动脉、793 条大脑中动脉和 195 条基底动脉的脑血管造影数据进行了测量，包括动脉直径、侧支和分叉角度以及动脉瘤偏离。使用计算流体动力学模拟分析血流动力学应力。在所有四个主要分叉处，显著（P<0.001）更多的动脉瘤向较小的分支和较小的侧支角度偏离，而不是向较大的分支和较大的侧支角度偏离。在血流直接冲击中心，总压力最大，而动压力、壁面切应力（WSS）、涡度和应变速率最小。峰值 1 和峰值 2 分别位于与母动脉形成较小和较大夹角的分支上。动压力（175.4±18.6 与 89.9±7.6 Pa）、WSS（28.9±7.4 与 15.7±5.3 Pa）、涡度（9874.6±973.4 与 7237.8±372.7 1/s）和应变率（9873.1±625.6 与 7648.3±472.5 1/s）以及峰值点与直接冲击中心之间的距离（1.9±0.8 与 1.3±0.3 mm），峰值 1 显著大于峰值 2（P<0.05 或 P<0.01）。此外，动脉瘤的偏离和峰值 1 总是在同一侧。总之，与母动脉形成较小夹角的分支与分叉顶点处动脉瘤形成的异常增强血流动力学应力有关。
