School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China.
Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, China; Department of Neurosurgery, Fujian Provincial Hospital, Fuzhou, China.
World Neurosurg. 2024 Jan;181:e918-e924. doi: 10.1016/j.wneu.2023.11.014. Epub 2023 Nov 8.
Multiple intracranial aneurysms (MIA) are prevalent. This study conducted hemodynamic calculations on MIA to analyze the effects of occlusion of the internal carotid artery (ICA) and middle cerebral artery (MCA) aneurysms on the hemodynamics of other arteries, as well as the issue of the treatment order for these aneurysms.
The models of 9 patients with MIA were selected for the study. A computational fluid dynamics model combining 1-dimension and 3-dimension was used to obtain the vascular flow pattern and wall pressure.
There was increased pressure at the MCA and anterior cerebral artery (ACA) after occlusion of the aneurysm at the ICA. However, the pressure at the ICA has hardly changed after the aneurysm occlusion at the MCA. Occlusion of the aneurysm of different sizes at the MCA had almost no impact on the pressure at the ICA and ACA. For small aneurysm, the pressure of the ACA and MCA increases with decreasing size of the aneurysm at the ICA. After occlusion of a large aneurysm at the ICA, the impact on the pressure of the ACA and MCA is almost the same as after occlusion of a medium-sized aneurysm.
If the treatment order of ICA and MCA aneurysms cannot be determined based on patient factors and aneurysm characteristics, the MCA aneurysm should be treated as a priority.
多发性颅内动脉瘤（MIA）较为常见。本研究对 MIA 进行血流动力学计算，分析颈内动脉（ICA）和大脑中动脉（MCA）动脉瘤闭塞对其他动脉血流动力学的影响，以及这些动脉瘤的治疗顺序问题。
选择 9 例 MIA 患者的模型进行研究。采用一维和三维相结合的计算流体动力学模型，获得血管流型和壁压。
ICA 动脉瘤闭塞后，MCA 和前脑动脉（ACA）压力增加。然而，MCA 动脉瘤闭塞后，ICA 的压力几乎没有变化。MCA 不同大小的动脉瘤闭塞对 ICA 和 ACA 的压力几乎没有影响。对于小动脉瘤，随着 ICA 动脉瘤的减小，ACA 和 MCA 的压力增加。ICA 大型动脉瘤闭塞后，对 ACA 和 MCA 压力的影响几乎与中等大小动脉瘤闭塞后相同。
如果不能根据患者因素和动脉瘤特征确定 ICA 和 MCA 动脉瘤的治疗顺序，MCA 动脉瘤应作为治疗的优先选择。
