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Effect of bifurcation in the hemodynamic changes and rupture risk of small intracranial aneurysm

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Abstract

The role of bifurcations is prominent in the intracranial aneurysm (IA) evaluation, and there are many contradictions and complexities in the rupture risk of small IA. Therefore, in the present study, the effect of bifurcation on the manner of hemodynamic changes and the rupture risk of the small middle cerebral artery (MCA) aneurysm is investigated. 3D anatomical models of the MCAs of 21 healthy subjects, 19 patients/IA/bifurcation, and 19 patients/IA were generated, and the models were analyzed by the computational fluid dynamic (CFD) analysis. The presence of bifurcation in the pathway of the blood flow in the parent artery of healthy subjects has reduced the maximum velocity, flow rate, and wall shear stress (WSS) by 25.8%, 38.6%, and 11.1%, respectively. The bifurcation decreased the maximum velocity and flow rate in the neck and sac of the aneurysm by 1.65~2.1 times, respectively. It increased the maximum WSS, and phase lag between the WSS graph of healthy subjects and patients by 12.8%~13.9% and 10.2%~40.4%, respectively. The effect of bifurcation on the Womersley number change in the aneurysm was insignificant, and the blood flow was in the laminar flow condition in all samples. The results also showed bifurcation increased the phase lag between the flow rate and pressure gradient graphs up to approximately 1.5 times. The rupture prediction index for patients/IA/bifurcation and patients/IA was 62.1%(CV = 4.1) and 51.8%(CV = 4.4), respectively. Thus, in equal conditions, the presence of bifurcation increased the probability of the rupture of the aneurysm by 19.9%.

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Acknowledgments

The author is very grateful to Dr. Amir Saeed Seddighi and Afsoun Seddighi, the neurosurgeons at the hospital Shohada Tajrish in Tehran, for the cooperation in this study.

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Authors and Affiliations

  1. Department of Biomedical Engineering, North Tehran Branch, Islamic Azad University, Tehran, Iran

    Seifollah Gholampour & Saeed Mehrjoo

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  1. Seifollah Gholampour
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  2. Saeed Mehrjoo
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Contributions

SG designed the study, data analysis, interpreted data, and wrote the final version of the manuscript. SM collected the data, data analysis, and wrote the manuscript. All authors approved the final manuscript.

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Correspondence to Seifollah Gholampour.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of North Tehran Branch, Islamic Azad University, Tehran, Iran, (Ethics committee of the biomedical research center with the ethic track number 18/14–2) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Furthermore, this article does not contain any studies with animals performed by any of the authors.

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According to the ethical standards of North Tehran Branch, Islamic Azad University, Tehran, Iran, 21 normal subjects and 19 patients provided informed consent before undergoing any study-specific procedures.

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Gholampour, S., Mehrjoo, S. Effect of bifurcation in the hemodynamic changes and rupture risk of small intracranial aneurysm. Neurosurg Rev 44, 1703–1712 (2021). https://doi.org/10.1007/s10143-020-01367-3

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  • DOI: https://doi.org/10.1007/s10143-020-01367-3

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