College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, People's Republic of China.
College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, People's Republic of China.
World Neurosurg. 2023 Jul;175:e115-e128. doi: 10.1016/j.wneu.2023.03.038. Epub 2023 Mar 11.
Most intracranial aneurysms (IAs) will be abnormal bulges on the walls of intracranial arteries that result from the dynamic interaction of geometric morphology, hemodynamics, and pathophysiology. Hemodynamics plays a key role in the origin, development, and rupture of IAs. In the past, hemodynamic studies of IAs were mostly based on the rigid wall hypothesis of computational fluid dynamics, and the influence of arterial wall deformation was ignored. We used fluid-structure interaction (FSI) to study the features of ruptured aneurysms, because it can solve this problem very well and the simulation will be more realistic.
A total of 12 IAs, 8 ruptured and 4 unruptured, at the middle cerebral artery bifurcation were studied using FSI to better identify the characteristics of ruptured IAs. We studied the differences in the hemodynamic parameters, including the flow pattern, wall shear stress (WSS), oscillatory shear index (OSI), and displacement and deformation of the arterial wall.
Ruptured IAs had a larger low WSS area and more complex, concentrated, and unstable flow. Also, the OSI was higher. In addition, the displacement deformation area at the ruptured IA was more concentrated and larger.
A large aspect ratio; a large height/width ratio; complex, unstable, and concentrated flow patterns with small impact areas; a large low WSS region; large WSS fluctuation, high OSI; and large displacement of the aneurysm dome could be risk factors associated with aneurysm rupture. If similar cases are encountered when simulation is used in the clinic, priority should be given to diagnosis and treatment.
大多数颅内动脉瘤(intracranial aneurysms,IAs)是颅内动脉壁动态相互作用的结果,表现为异常膨出,涉及几何形态、血流动力学和病理生理学等多方面。血流动力学在 IAs 的起源、发展和破裂中起关键作用。过去,IAs 的血流动力学研究大多基于计算流体动力学的刚性壁假设,忽略了动脉壁变形的影响。我们使用流固耦合(fluid-structure interaction,FSI)来研究破裂动脉瘤的特征,因为它可以很好地解决这个问题,并且模拟将更加真实。
使用 FSI 研究了 12 个大脑中动脉分叉处的动脉瘤,其中 8 个破裂,4 个未破裂,以更好地识别破裂动脉瘤的特征。我们研究了血流动力学参数的差异,包括流型、壁切应力(wall shear stress,WSS)、振荡剪切指数(oscillatory shear index,OSI)以及动脉壁的位移和变形。
破裂动脉瘤的低 WSS 区域较大,血流更加复杂、集中且不稳定。此外,OSI 更高。此外,破裂动脉瘤的位移变形区域更集中且更大。
大的长宽比、大的高度/宽度比、具有小冲击面积的复杂、不稳定和集中的流型、大的低 WSS 区域、大的 WSS 波动、高 OSI 和大的瘤顶位移可能是与动脉瘤破裂相关的危险因素。如果在临床模拟中遇到类似病例,应优先考虑诊断和治疗。