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关于颅内动脉瘤壁管腔曲率在决定其力学响应、局部血液动力学和破裂可能性方面所起的主要作用。

On the major role played by the lumen curvature of intracranial aneurysms walls in determining their mechanical response, local hemodynamics, and rupture likelihood.

机构信息

São Paulo State University (UNESP), School of Engineering, Bauru, Department of Mechanical Engineering, Av. Engenheiro Luiz Edmundo Carrijo Coube, 14-01, 17033-360, Bauru, SP, Brazil.

University College Dublin (UCD), School of Mechanical and Materials Engineering, Dublin, Ireland.

出版信息

Comput Biol Med. 2023 Sep;163:107178. doi: 10.1016/j.compbiomed.2023.107178. Epub 2023 Jun 17.

Abstract

The properties of intracranial aneurysms (IAs) walls are known to be driven by the underlying hemodynamics adjacent to the IA sac. Different pathways exist explaining the connections between hemodynamics and local tissue properties. The emergence of such theories is essential if one wishes to compute the mechanical response of a patient-specific IA wall and predict its rupture. Apart from the hemodynamics and tissue properties, one could assume that the mechanical response also depends on the local morphology, more specifically, the curvature of the luminal surface, with larger values at highly-curved wall portions. Nonetheless, this contradicts observations of IA rupture sites more often found at the dome, where the curvature is lower. This seeming contradiction indicates a complex interaction between the hemodynamics adjacent to the aneurysm wall, its morphology, and mechanical response, which warrants further investigation. This was the main goal of this work. We accomplished this by analyzing the stress and stretch fields in different regions of the wall for a sample of IAs, which have been classified based on particular hemodynamics conditions and lumen curvature. Pulsatile numerical simulations were performed using the one-way fluid-solid interaction strategy implemented in OpenFOAM (solids4foam toolbox). We found that the variable best correlated with regions of high stress and stretch was the lumen curvature. Additionally, our data suggest a connection between the local curvature and particular hemodynamics conditions adjacent to the wall, indicating that the lumen curvature is a property that could be used to assess both mechanical response and hemodynamic conditions, and, moreover, suggest new rupture indicators based on the curvature.

摘要

颅内动脉瘤(IA)壁的特性已知是由紧邻 IA 囊的潜在血液动力学驱动的。存在不同的途径来解释血液动力学和局部组织特性之间的联系。如果希望计算特定患者的 IA 壁的力学响应并预测其破裂,那么这些理论的出现是必不可少的。除了血液动力学和组织特性之外,人们还可以假设机械响应还取决于局部形态,更具体地说,取决于管腔表面的曲率,在曲率较大的壁部分曲率较大。然而,这与在穹顶处更常发现的 IA 破裂部位的观察结果相矛盾,穹顶处的曲率较低。这种看似矛盾的现象表明,紧邻动脉瘤壁的血液动力学、其形态和力学响应之间存在复杂的相互作用,这需要进一步研究。这是这项工作的主要目标。我们通过分析在基于特定血液动力学条件和管腔曲率分类的 IA 壁的不同区域中的应力和拉伸场来实现这一目标。使用在 OpenFOAM 中实现的单向流固相互作用策略(solids4foam 工具箱)进行脉动数值模拟。我们发现与高应力和拉伸区域最相关的变量是管腔曲率。此外,我们的数据表明局部曲率与壁附近的特定血液动力学条件之间存在联系,这表明管腔曲率是一种可以用于评估力学响应和血液动力学条件的特性,并且还基于曲率提出了新的破裂指标。

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