Flow instability detected in ruptured versus unruptured cerebral aneurysms at the internal carotid artery |
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| Affiliation: | 1. School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China;2. Shanghai Jiao Tong University and Chiba University International Cooperative Research Centre (SJTU-CU ICRC), Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China;3. Graduate School of Engineering, Chiba University, 1-33, Yayoi-cho, Inage-ku, Chiba-shi, Chiba 2638522, Japan;1. Department of Cardiovascular Surgery, Chiba Kaihin Municipal Hospital, Chiba, Japan;2. Graduate School of Engineering, Chiba University, Chiba, Japan;3. Section of Pediatric Radiology, Department of Radiology, University of Colorado, Aurora, Colorado;1. School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China;2. Department of Computer Science, University of North Carolina at Charlotte, NC, USA;3. Peking Union Medical College Hospital, Beijing, China;4. Department of Computer Science, Rutgers University, Piscataway, NJ, USA;1. Department of Radiology, Jagiellonian University Medical College, Kraków, Poland;2. Department of General and Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland;1. Biomedical Flow Dynamics Laboratory, Institute of Fluid Science, Tohoku University, Sendai, 980-8577, Miyagi, Japan;2. College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria, Egypt |
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| Abstract: | Flow instability has emerged as a new hemodynamic metric hypothesized to have potential value in assessing the rupture risk of cerebral aneurysms. However, diverse findings have been reported in the literature. In the present study, high-resolution hemodynamic simulations were performed retrospectively on 35 aneurysms (10 ruptured & 25 unruptured) located at the internal carotid artery (ICA). Simulated hemodynamic parameters were statistically compared between the ruptured and unruptured aneurysms, with emphasis on examining the correlation of flow instability with the status of aneurysm rupture. Pronounced flow instability was detected in 20% (2 out of 10) of the ruptured aneurysms, whereas in 44% (11 out of 25) of the unruptured aneurysms. Statistically, the flow instability metric (quantified by the temporally and spatially averaged fluctuating kinetic energy over the aneurysm sac) did not differ significantly between the ruptured and unruptured aneurysms. In contrast, low wall shear stress area (LSA) and pressure loss coefficient (PLC) exhibited significant correlations with the status of aneurysm rupture. In conclusion, the present study suggests that the presence of flow instability may not correlate closely with the status of aneurysm rupture, at least for ICA aneurysms. On the other hand, the retrospective nature of the study and the small sample size may have to some extent compromised the reliability of the conclusion, and therefore large-scale prospective studies would be needed to further address the issue. |
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| Keywords: | Cerebral aneurysm Flow instability Wall shear stress Computational fluid dynamics Internal carotid artery |
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