J Korean Neurosurg Soc.  2018 Nov;61(6):689-699. 10.3340/jkns.2018.0155.

Wall Shear Stress and Flow Patterns in Unruptured and Ruptured Anterior Communicating Artery Aneurysms Using Computational Fluid Dynamics

Affiliations
  • 1Department of Bionanosystem Engineering, Chonbuk National University, Jeonju, Korea.
  • 2Division of Mechanical Design Engineering, Chonbuk National University, Jeonju, Korea. 0311dhlee@jbnu.ac.kr
  • 3Department of Radiology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea. kwak8141@jbnu.ac.kr
  • 4Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.

Abstract


OBJECTIVE
The goal of this study was to compare several parameters, including wall shear stress (WSS) and flow pattern, between unruptured and ruptured anterior communicating artery (ACoA) aneurysms using patient-specific aneurysm geometry.
METHODS
In total, 18 unruptured and 24 ruptured aneurysms were analyzed using computational fluid dynamics (CFD) models. Minimal, average, and maximal wall shear stress were calculated based on CFD simulations. Aneurysm height, ostium diameter, aspect ratio, and area of aneurysm were measured. Aneurysms were classified according to flow complexity (simple or complex) and inflow jet (concentrated or diffused). Statistical analyses were performed to ascertain differences between the aneurysm groups.
RESULTS
Average wall shear stress of the ruptured group was greater than that of the unruptured group (9.42% for aneurysm and 10.38% for ostium). The average area of ruptured aneurysms was 31.22% larger than unruptured aneurysms. Simple flow was observed in 14 of 18 (78%) unruptured aneurysms, while all ruptured aneurysms had complex flow (p < 0.001). Ruptured aneurysms were more likely to have a concentrated inflow jet (63%), while unruptured aneurysms predominantly had a diffused inflow jet (83%, p=0.004).
CONCLUSION
Ruptured aneurysms tended to have a larger geometric size and greater WSS compared to unruptured aneurysms, but the difference was not statistically significant. Flow complexity and inflow jet were significantly different between unruptured and ruptured ACoA aneurysms.

Keyword

Aneurysm; Anterior communicating artery aneurysm; Computational fluid dynamics; Wall shear stress; Flow pattern

MeSH Terms

Aneurysm
Aneurysm, Ruptured
Arteries
Hydrodynamics*
Intracranial Aneurysm*

Figure

  • Fig. 1. The wall shear stress distributions for 18 unruptured aneurysms at end-diastole.

  • Fig. 2. The wall shear stress distributions for 24 ruptured aneurysms at end-diastole.

  • Fig. 3. Scattergram with regression analysis of average WSS at unruptured and ruptured aneurysms. Average WSS at unruptured and ruptured aneurysms did not correlate with the height (A), ostium diameter (B), aspect ratio (C), or area of the aneurysms (D). WSS : wall shear stress, UR : unruptured aneurysm, RU : ruptured aneurysm, N.S. : not significant.

  • Fig. 4. Representative cases of aneurysms with flow complexity. Top row (aneurysm A and B), unruptured aneurysms with simple flow; bottom row (aneurysm C and D), ruptured aneurysms with complex flow; recirculation zone marked with number and arrow. Two recirculation areas were involved in aneurysm C, and three recirculation zones were observed in aneurysm D.

  • Fig. 5. Representative cases of aneurysms with inflow jet. Top row (aneurysm E and F), unruptured aneurysms with diffused inflow; bottom row (aneurysm G and H), ruptured aneurysms with concentrated inflow. In aneurysm E and F, the flow spread immediately after blood flow entered. In aneurysm G and H, concentrated inflow was observed when the blood entered the dome of aneurysm.


Reference

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