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Hemodynamic differences of posterior communicating artery aneurysms between adult and fetal types of posterior cerebral artery

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Abstract

Background

The recanalization of posterior communicating artery (PCoA) aneurysms after endovascular treatment has been analyzed by various factors. However, the differences between adult and fetal types of posterior cerebral artery (PCA) have not been fully investigated. The main aim of this study was to investigate hemodynamic differences of PCoA aneurysms between adult and fetal types using computational fluid dynamics (CFD).

Methods

Fifty-five PCoA aneurysms were evaluated by 3D CT angiography and divided into unruptured aneurysms with adult-type or fetal-type PCAs (19 cases, UA group; 9 cases, UF group) and ruptured aneurysms with adult-type or fetal-type PCAs (17 cases, RA group; 10 cases, RF group). These native aneurysms were analyzed by CFD regarding morphological and hemodynamic characteristics. To evaluate simulated endovascular treatment of aneurysms, CFD was performed using porous media modeling.

Results

Morphologically, the RA group had significantly smaller parent artery diameter (2.91 mm vs. 3.49 mm, p=0.005) and higher size ratio (2.54 vs. 1.78, p=0.023) than the RF group. CFD revealed that the UA group had significantly lower oscillatory shear index (OSI) (0.0032 vs. 0.0078, p=0.004) than the UF group and that the RA group had lower WSS (3.09 vs. 11.10, p=0.001) and higher OSI (0.014 vs. 0.006, p=0.031) than the RF group, while the RF group presented significantly higher intra-aneurysmal flow velocity (0.19 m/s vs. 0.061 m/s, p=0.002) than the RA group. Porous media modeling of simulated treatment revealed higher residual flow volume in the fetal-type groups.

Conclusions

These results suggested that PCoA aneurysms with fetal-type PCAs had different morphological features and hemodynamic characteristics compared with those with adult-type PCAs, leading to high risks of recanalization.

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Data availability

All data relevant to the study are included in the article or uploaded as supplementary information.

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Funding

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Authors and Affiliations

  1. Department of Neurosurgery, Kuwana City Medical Center, 3-11, Kotobuki-Cho, Kuwana, Mie, 511-0061, Japan

    Katsuhiro Tanaka

  2. Department of Neurosurgery, NHO Mie Chuo Medical Center, Tsu, Mie, Japan

    Kazuhiro Furukawa & Fujimaro Ishida

  3. Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

    Hidenori Suzuki

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Contributions

Conceptualization: Katsuhiro Tanaka, Fujimaro Ishida

Data curation: Katsuhiro Tanaka, Kazuhiro Furukawa, Fujimaro Ishida

Formal analysis: Katsuhiro Tanaka, Kazuhiro Furukawa, Fujimaro Ishida

Methodology: Kazuhiro Furukawa, Fujimaro Ishida

Project administration: Katsuhiro Tanaka, Fujimaro Ishida

Software: Kazuhiro Furukawa, Fujimaro Ishida

Supervision: Fujimaro Ishida, Hidenori Suzuki

Validation: Katsuhiro Tanaka, Fujimaro Ishida

Visualization: Katsuhiro Tanaka, Fujimaro Ishida

Writing–original draft: Katsuhiro Tanaka

Writing–review and editing: Katsuhiro Tanaka, Fujimaro Ishida, Hidenori Suzuki

Corresponding author

Correspondence to Katsuhiro Tanaka.

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This study was conducted in accordance with the guideline and under the approval of the ethics review board of Mie Chuo Medical Center (approval number: MCERB 201820).

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Tanaka, K., Furukawa, K., Ishida, F. et al. Hemodynamic differences of posterior communicating artery aneurysms between adult and fetal types of posterior cerebral artery. Acta Neurochir 165, 3697–3706 (2023). https://doi.org/10.1007/s00701-023-05840-y

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