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。

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Roland Schwab, Rebecca Janiszewski, Erelle Fuchs, Maximilian Thormann, Belal Neyazi, Vanessa Magdalena Swiatek, I Erol Sandalcioglu, Philipp Berg, Daniel Behme, Samuel Voß, Janneck Stahl
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引用次数: 0

摘要

背景:关于后交通动脉血流特征(PCOM)的分支动脉瘤cs的研究很少。胎儿后交通动脉(fPCOM)的存在降低了血管内治疗后PCOM动脉瘤完全闭塞的可能性。因此,PCOM动脉瘤的解剖变异是血管内治疗的主要挑战。本研究探讨了胎儿型或成人型PCOM动脉瘤的血流动力学变化。方法:收集14例PCOM连接处分叉动脉瘤的3D-DSA数据。9例患者表现为fPCOM, 5例为成人PCOM (aPCOM)。使用基于图像的血流模拟提取了患者特定的3D模型,该模型包含至少一个前循环动脉瘤远端分支以及PCOM本身。计算所有动脉瘤模型的7个血流动力学参数,以表征动脉瘤内血流。在每个模型中,人为地改变PCOM流出量以代表fPCOM和aPCOM条件,从而进行了28次模拟。结果:胎儿型PCOM表现出更高的动脉瘤内平均流速(中位数0.09比0.06 m/s)、最大流速(0.17比0.14 m/s)、平均壁剪应力(1.67比1.27 Pa)、颈部流入率(40.9比22.4 ml/min)和流入浓度指数(0.56比0.40),脉搏指数较低(1.73比1.89)。这些差异显著,而平均振荡剪切指数差异不显著。结论:解剖变异影响PCOM分岔动脉瘤的血流动力学参数。特别是,fPCOM的存在对动脉瘤内流动动力学有不利的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Neuroradiology
Neuroradiology 医学-核医学
CiteScore
5.30
自引率
3.60%
发文量
214
审稿时长
4-8 weeks
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.
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