Roland Schwab, Rebecca Janiszewski, Erelle Fuchs, Maximilian Thormann, Belal Neyazi, Vanessa Magdalena Swiatek, I Erol Sandalcioglu, Philipp Berg, Daniel Behme, Samuel Voß, Janneck Stahl
{"title":"胎儿型后交通动脉增加后交通动脉分叉动脉瘤的血流动力学应力:一项基于cfd的分析。","authors":"Roland Schwab, Rebecca Janiszewski, Erelle Fuchs, Maximilian Thormann, Belal Neyazi, Vanessa Magdalena Swiatek, I Erol Sandalcioglu, Philipp Berg, Daniel Behme, Samuel Voß, Janneck Stahl","doi":"10.1007/s00234-025-03785-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Backround: </strong>The cs of bifurcation aneurysms in the posterior communicating arterflow characteristiy (PCOM) have rarely been studied. The likelihood of a complete PCOM aneurysm occlusion after endovascular treatment is reduced with the presence of a fetal posterior communicating artery (fPCOM). As a result, anatomical variations in PCOM aneurysms represent a major challenge for the endovascular treatment. This study addresses hemodynamic variations in PCOM aneurysms of either fetal or adult type.</p><p><strong>Methods: </strong>3D-DSA data of 14 patients with bifurcation aneurysms located in the PCOM junction were collected. Nine patients presented with a fPCOM and five patients an adult PCOM (aPCOM). Patient-specific 3D models containing at least one bifurcation distal the aneurysm in the anterior circulation as well as the PCOM itself were extracted using image-based blood flow simulations. Seven hemodynamic parameters were calculated for all aneurysm models to characterize the intra-aneurysmal blood flow. The PCOM outflow was artificially varied to represent both fPCOM and aPCOM conditions for each model resulting in 28 simulations.</p><p><strong>Results: </strong>Fetal‑type PCOM showed higher intra‑aneurysmal mean velocity (median 0.09 vs. 0.06 m/s), maximum velocity (0.17 vs. 0.14 m/s), averaged wall shear stress (1.67 vs. 1.27 Pa), neck inflow rate (40.9 vs. 22.4 ml/min), and inflow concentration index (0.56 vs. 0.40), with lower pulsatility index (1.73 vs. 1.89). Those differences were significant whereas mean oscillatory shear index did not differ significantly.</p><p><strong>Conclusion: </strong>The presence of anatomical variations affects the hemodynamic parameters of PCOM bifurcation aneurysms. In particular, the presence of an fPCOM has an unfavorable effect on the intra-aneurysmal flow dynamics.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fetal-type posterior communicating artery increases hemodynamic stress in posterior communicating artery bifurcation aneurysms: a CFD-based analysis.\",\"authors\":\"Roland Schwab, Rebecca Janiszewski, Erelle Fuchs, Maximilian Thormann, Belal Neyazi, Vanessa Magdalena Swiatek, I Erol Sandalcioglu, Philipp Berg, Daniel Behme, Samuel Voß, Janneck Stahl\",\"doi\":\"10.1007/s00234-025-03785-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Backround: </strong>The cs of bifurcation aneurysms in the posterior communicating arterflow characteristiy (PCOM) have rarely been studied. The likelihood of a complete PCOM aneurysm occlusion after endovascular treatment is reduced with the presence of a fetal posterior communicating artery (fPCOM). As a result, anatomical variations in PCOM aneurysms represent a major challenge for the endovascular treatment. This study addresses hemodynamic variations in PCOM aneurysms of either fetal or adult type.</p><p><strong>Methods: </strong>3D-DSA data of 14 patients with bifurcation aneurysms located in the PCOM junction were collected. Nine patients presented with a fPCOM and five patients an adult PCOM (aPCOM). Patient-specific 3D models containing at least one bifurcation distal the aneurysm in the anterior circulation as well as the PCOM itself were extracted using image-based blood flow simulations. Seven hemodynamic parameters were calculated for all aneurysm models to characterize the intra-aneurysmal blood flow. The PCOM outflow was artificially varied to represent both fPCOM and aPCOM conditions for each model resulting in 28 simulations.</p><p><strong>Results: </strong>Fetal‑type PCOM showed higher intra‑aneurysmal mean velocity (median 0.09 vs. 0.06 m/s), maximum velocity (0.17 vs. 0.14 m/s), averaged wall shear stress (1.67 vs. 1.27 Pa), neck inflow rate (40.9 vs. 22.4 ml/min), and inflow concentration index (0.56 vs. 0.40), with lower pulsatility index (1.73 vs. 1.89). Those differences were significant whereas mean oscillatory shear index did not differ significantly.</p><p><strong>Conclusion: </strong>The presence of anatomical variations affects the hemodynamic parameters of PCOM bifurcation aneurysms. In particular, the presence of an fPCOM has an unfavorable effect on the intra-aneurysmal flow dynamics.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-025-03785-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03785-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Fetal-type posterior communicating artery increases hemodynamic stress in posterior communicating artery bifurcation aneurysms: a CFD-based analysis.
Backround: The cs of bifurcation aneurysms in the posterior communicating arterflow characteristiy (PCOM) have rarely been studied. The likelihood of a complete PCOM aneurysm occlusion after endovascular treatment is reduced with the presence of a fetal posterior communicating artery (fPCOM). As a result, anatomical variations in PCOM aneurysms represent a major challenge for the endovascular treatment. This study addresses hemodynamic variations in PCOM aneurysms of either fetal or adult type.
Methods: 3D-DSA data of 14 patients with bifurcation aneurysms located in the PCOM junction were collected. Nine patients presented with a fPCOM and five patients an adult PCOM (aPCOM). Patient-specific 3D models containing at least one bifurcation distal the aneurysm in the anterior circulation as well as the PCOM itself were extracted using image-based blood flow simulations. Seven hemodynamic parameters were calculated for all aneurysm models to characterize the intra-aneurysmal blood flow. The PCOM outflow was artificially varied to represent both fPCOM and aPCOM conditions for each model resulting in 28 simulations.
Results: Fetal‑type PCOM showed higher intra‑aneurysmal mean velocity (median 0.09 vs. 0.06 m/s), maximum velocity (0.17 vs. 0.14 m/s), averaged wall shear stress (1.67 vs. 1.27 Pa), neck inflow rate (40.9 vs. 22.4 ml/min), and inflow concentration index (0.56 vs. 0.40), with lower pulsatility index (1.73 vs. 1.89). Those differences were significant whereas mean oscillatory shear index did not differ significantly.
Conclusion: The presence of anatomical variations affects the hemodynamic parameters of PCOM bifurcation aneurysms. In particular, the presence of an fPCOM has an unfavorable effect on the intra-aneurysmal flow dynamics.
期刊介绍:
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.