Xue-Jing Zhang1, Cong-Hui Li2, Wei-Li Hao3, Dong-Hai Zhang4, Chun-Feng Ren5, Bu-Lang Gao6. 1. Department of Neurosurgery, The First Hospital, Hebei Medical University, Shijiazhuang, Hebei Province, China; Department of Medical Research, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei Province, China. 2. Department of Neurosurgery, The First Hospital, Hebei Medical University, Shijiazhuang, Hebei Province, China. 3. Department of Medical Research, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei Province, China. 4. Henan Balance Medical Laboratory, Zhengzhou, Henan Province, China. 5. Clinical Laboratory, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China. 6. Department of Neurosurgery, The First Hospital, Hebei Medical University, Shijiazhuang, Hebei Province, China; Department of Medical Research, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei Province, China. Electronic address: browngao@163.com.
Abstract
OBJECTIVE: To investigate the relationship of anterior cerebral artery (ACA) bifurcation angles with hemodynamic stresses for aneurysm initiation. METHODS: Forty patients with or without anterior communicating artery aneurysms were enrolled, and 3 patients with ACA bifurcation angles of 169.0°, 136.9°, and 73.2°, respectively, were entered into computational fluid dynamics analysis for hemodynamic stresses. RESULTS: Larger bifurcation angles had a larger direct flow impinging zone and larger peak pressure area. In the direct flow impinging center, the total pressure was the highest, whereas the other stresses were the lowest. As blood flowed distally, the total pressure decreased rapidly, whereas all other parameters increased quickly to their peaks. The hemodynamic peak distance was decreased as the bifurcation angle became narrower. The total pressure summit and the peak hemodynamic stresses all decreased with the decrease of bifurcation angles. The distance between the hemodynamic peaks was the smallest at 73.2° compared with larger angles. A significant (P < 0.01) positive linear correlation existed in the ACA bifurcation angle with the distance between hemodynamic stress peaks or in the ACA branch diameter with the distance from the direct impinging center to the ipsilateral hemodynamic stress peak. The hemodynamic stresses on the aneurysm dome were significantly (P < 0.001) smaller than at the aneurysm initiation site. CONCLUSIONS: Larger bifurcation angles may lead to abnormally enhanced hemodynamic stresses, enlarged zones of direct flow impingement, and increased distance between hemodynamic stress peaks to damage the vascular wall for aneurysm initiation on the bifurcation apex wall.
OBJECTIVE: To investigate the relationship of anterior cerebral artery (ACA) bifurcation angles with hemodynamic stresses for aneurysm initiation. METHODS: Forty patients with or without anterior communicating artery aneurysms were enrolled, and 3 patients with ACA bifurcation angles of 169.0°, 136.9°, and 73.2°, respectively, were entered into computational fluid dynamics analysis for hemodynamic stresses. RESULTS: Larger bifurcation angles had a larger direct flow impinging zone and larger peak pressure area. In the direct flow impinging center, the total pressure was the highest, whereas the other stresses were the lowest. As blood flowed distally, the total pressure decreased rapidly, whereas all other parameters increased quickly to their peaks. The hemodynamic peak distance was decreased as the bifurcation angle became narrower. The total pressure summit and the peak hemodynamic stresses all decreased with the decrease of bifurcation angles. The distance between the hemodynamic peaks was the smallest at 73.2° compared with larger angles. A significant (P < 0.01) positive linear correlation existed in the ACA bifurcation angle with the distance between hemodynamic stress peaks or in the ACA branch diameter with the distance from the direct impinging center to the ipsilateral hemodynamic stress peak. The hemodynamic stresses on the aneurysm dome were significantly (P < 0.001) smaller than at the aneurysm initiation site. CONCLUSIONS: Larger bifurcation angles may lead to abnormally enhanced hemodynamic stresses, enlarged zones of direct flow impingement, and increased distance between hemodynamic stress peaks to damage the vascular wall for aneurysm initiation on the bifurcation apex wall.
Authors: Wojciech Kaspera; Karolina Ćmiel-Smorzyk; Wojciech Wolański; Edyta Kawlewska; Anna Hebda; Marek Gzik; Piotr Ładziński Journal: Sci Rep Date: 2020-02-06 Impact factor: 4.379
Authors: Mikołaj Zimny; Edyta Kawlewska; Anna Hebda; Wojciech Wolański; Piotr Ładziński; Wojciech Kaspera Journal: BMC Neurol Date: 2021-07-19 Impact factor: 2.474