Risk Analysis of Unruptured Aneurysms Using Computational Fluid Dynamics Technology: Preliminary Results

Qian, Yi; Takao, Hiroyuki; Umezu, Mitsuo; Murayama, Yuichi

doi:10.3174/ajnr.a2655

Cited by 119 publications

(90 citation statements)

References 18 publications

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“…Our previous study indicated that there is no significant difference between the average volume of pulsatile flow and steady flow. 12 Thus in this study, calculations were performed with a steady flow rate (218 mL/min) at the parent artery inlet for idealized models by using the peak flow rate in the MCA. 23 To characterize the flow regimen in the parent artery and branches, we calculated the Reynolds number, indicating the occurrence of laminar blood flow in all models (at the inlet and outlet, the Reynolds number based on maximum velocity was 340 and 360, respectively).…”

Section: Blood Flow Modeling and Boundary Conditionsmentioning

confidence: 99%

“…A further study concentrating on EL of 4 ruptured and 26 unruptured ICA-posterior communicating artery aneurysms found that the EL of ruptured cases was 5 times higher than that of unruptured cases. 12 Moreover, a study of 210 cerebral aneurysms showed the presence of a higher kinetic energy ratio in ruptured aneurysms compared with unruptured ones. 13 A study of 26 aneurysms also indicated that a larger region of low WSS was associated with ruptured aneurysms.…”

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confidence: 99%

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Effect of Bifurcation Angle Configuration and Ratio of Daughter Diameters on Hemodynamics of Bifurcation Aneurysms

Farnoush

Avolio

Qian

2012

AJNR Am J Neuroradiol

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Section: Blood Flow Modeling and Boundary Conditionsmentioning

confidence: 99%

mentioning

confidence: 99%

Effect of Bifurcation Angle Configuration and Ratio of Daughter Diameters on Hemodynamics of Bifurcation Aneurysms

Farnoush

Avolio

Qian

2012

AJNR Am J Neuroradiol

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“…Bu tetkik yönte-miyle 2-3 mm'den daha küçük anevrizmaların değerlendirilme-si ve tanınmasının güç olduğu yönünde bilgiler bulunmaktadır. Üç boyutlu bilgisayarlı tomografi ve üç boyutlu dijital subtraksiyon anjiografiden sonra küçük boyutlu anevrizmaların tanım-lanmasının kolaylaştığı açıktır [1,3]. Ancak her şeye rağmen kü-çük boyutlu anevrizmaların gözden kaçma şansı her zaman için bulunmaktadır.…”

Section: Discussionunclassified

“…Hastalığın nedenleri arasında sakküler anevrizmalar sıklıkla bulunmaktadır [1][2][3]. Subaraknoid kanamaya neden olan anevrizmalar genellikle tekli olarak görülürler [1][2][3][4].…”

Section: Introductionunclassified

“…Anevrizma yüzeyinin düzgün olmaması, pseudoanevrizma varlığı gibi bulgular kanayan anevrizmanın hangisi olduğu hakkında bilgi verebilir. Dijital substarksiyon anjiografi (DSA)ve üç boyutlu dijital subtraksiyon anjiografik (3B-DSA) bulgular anevrizmanın lokalizasyonu, perforan damarlarla olan ilişkisi, aynı damarda ikincil anevrizmaların varlığı ve anevrizmanın yüzeyi hakkında detaylı ve güvenilir bulguları sağlamaktadır [3]. Bilgisayarlı tomografi (BT) bulguları da bu verilere eklendiğinde kanayan anevrizmanın hangisi olduğu hakkında fikir sahibi olunabilir [3].…”

Section: Introductionunclassified

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Surgical Treatment of Internal Carotid Bifurcation and Pericallosal Artery Aneurysms with Unilatera

Çokluk¹

2014

Ann Clin Anal Med

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ÖzetAmaç: Anevrizmalar subaraknoid kanamanın başta gelen nedenleri arasında-dır. En sık görülen anevrizma şekli tekli anevrizmadır. Ancak nadir olmamakla birlikte çoklu anevrizmalar da görülebilir. Gereç ve Yöntem: Daha önceden rüptüre olmuş sol internal karotid arter bifurkasyon anevrizması nedeniyle ameliyat edilmiş 55 yaşında kadın olgu bir ay kadar sonra insidental sağ internal karotid bifurkasyon ve perikallosal arter anevrizması nedeniyle hastaneye, cerrahi tedavi için yatırıldı. Bulgular: Cerrahi tedavi sırasında, karşı taraf pupilla hizası saçlı deri sınırından başlayarak ipsilateral pterional bölge-ye gelen cilt insizyonu planlandı. Bu insizyon sağ para median kraniyotomi ve pteriyonel kraniotomi yapılmasına imkan sağlamaktaydı. Öncelikle pteriyonel kraniyotomi yapıldı. Silviyan diseksiyonu takiben internal karotid arter bifurkasyon bölgesinde lokalize anevrizmaya ulaşıldı. Anevrizma diseke edilerek klipe edildi. Daha sonra sağ frontal paramedian kraniyotomi yapıldı ve interhemisferik fissürden ilerlenerek perikallosal arterde yerleşik anevrizma kliplendi. Tartışma: Bu tip çoklu anevrizma yerleşimlerinde klasik pteriyonel cilt insizyonu tek taraflı frontopteriyonel insizyona modifiye edilerek tek seferde iki kraniyotomi ile heriki anevrizma da tedavi edilebilir. Anahtar Kelimelerİnternal Karotid Arter Bifurkasyon; Anevrizma; Perikallosal Arter Anevrizması Results: During surgical treatment, a modified pterional skin incision was planned starting from contrlateral pupilla level at the point hairy skin area and extending curvelinearly to the ipsilateral pterional region. This modified craniotomy permitted to do pterional craniotomy and left paramedian craniotomy in the same time. Pterional craniotomy was done firstly. Sylvian dissection was performed to reaching down the aneurysmatic dilatation at the location of internal carotid artery bifurcation. Aneurysm was dissected and clipped. Secondly right paramedian frontal craniotomy was performed. Interhemisferic approach was done in the clipping of the pericallosal aneurysm.Discussion: In such cases the frontopterional skin incision (a modification of pterional incision) may be used in the performing of pterional and paramedian frontal craniotomy.

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Incomplete stent expansion in flow‐diversion treatment affects aneurysmal haemodynamics: a quantitative comparison of treatments affected by different severities of malapposition occurring in different segments of the parent artery

Zhang

Sugiyama

et al. 2021

Numer Methods Biomed Eng

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Incomplete stent expansion (IncSE) is occasionally seen in flow-diversion (FD) treatment of intracranial aneurysms; however, its haemodynamic consequences remain inconclusive. Through a parametric study, we quantify the aneurysmal haemodynamics subject to different severities of IncSE occurring in different portions of the stent. Two patient cases with IncSE confirmed in vivo were studied. To investigate a wider variety of IncSE scenarios, we modelled IncSE at two severity levels respectively located in the proximal, central, or distal segment of a stent, yielding a total of 14 treatment scenarios (including the ideal deployment). We examined stent wire configurations in 14 scenarios and resolved aneurysm haemodynamics through computational fluid dynamics (CFD). A considerable degradation of aneurysm flow-reduction performance was observed when central or distal IncSE occurred, with the maximal elevations of the inflow rate (IR) and energy loss (EL) being 10% and 15%. The underlying mechanism might be the increased resistance for flow to remain within the FD stent, which forces more blood to leak into the aneurysm sac. Counter-intuitively, a slight reduction of aneurysm inflow was associated with proximal IncSE, with the maximal further reduction of the IR and EL being 5% and 8%. This may be due to the disruption of the predominant parent-artery flow by the collapsed wires, which decreased the strength and altered the direction of aneurysmal inflow. The effects of IncSE vary greatly with the location of occurrence, revealing the importance of performing individualised, patient-specific risk assessment before treatment.

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Risk Analysis of Unruptured Aneurysms Using Computational Fluid Dynamics Technology: Preliminary Results

Cited by 119 publications

References 18 publications

Effect of Bifurcation Angle Configuration and Ratio of Daughter Diameters on Hemodynamics of Bifurcation Aneurysms

Effect of Bifurcation Angle Configuration and Ratio of Daughter Diameters on Hemodynamics of Bifurcation Aneurysms

Surgical Treatment of Internal Carotid Bifurcation and Pericallosal Artery Aneurysms with Unilatera

Incomplete stent expansion in flow‐diversion treatment affects aneurysmal haemodynamics: a quantitative comparison of treatments affected by different severities of malapposition occurring in different segments of the parent artery

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