Hemodynamic findings associated with intraoperative appearances of intracranial aneurysms
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Intracranial aneurysms can be classified into thick-walled aneurysms and thin-walled aneurysms according to their intraoperative appearances; previous publications have revealed that different kinds of intraoperative appearances were associated with intraoperative rupture and postoperative complications. Here, we tried to evaluate the association between hemodynamic features and aneurysm wall appearance using computational fluid dynamics (CFD) method. Forty-one consecutive patients with unruptured middle cerebral artery (MCA) bifurcation aneurysms were included in our study. Based on the appearances observed under the microscope, aneurysms were classified into two different types: thick-walled and thin-walled aneurysms. Preoperative computed tomographic angiography (CTA) was used for geometry reconstruction and CFD analysis. Morphological and hemodynamic parameters were compared between the two groups. Eighteen aneurysms were classified as thick-walled atherosclerotic ones according to their intraoperative appearances. Compared with thin-walled aneurysms, aneurysms with atherosclerotic changes had larger geometry parameters (aneurysm depth, maximum height, diameter, aspect ratio, size ratio), lower wall shear stress (WSS), and larger low WSS area ratio (LSAR). Thick-walled aneurysms characterized by atherosclerotic changes are associated with low WSS and larger LSAR. CFD may be a useful tool for discriminating the intraoperative appearance of cerebral aneurysms.
KeywordsCerebral aneurysm Hemodynamics Wall shear stress Intraoperative appearance Atherosclerotic change
This work was supported by the National Key Research and Development Program of National Key Basic Research Development of China (Grant No. 2016YFC1301800) and the projects of National Natural Science Foundation of China (Grant No. 81471210 and 81671129).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
The need for written informed consent was waived, due to the retrospective nature of this study.
This study has been approved by the ethics committee of Beijing Tiantan Hospital, Capital Medical University.
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