Hemodynamic Factor Evaluation Using Computational Fluid Dynamics Analysis for De Novo Bleb Formation in Unruptured Intracranial Aneurysms. (16th November 2020)

• Record Type: Journal Article
• Authors: Uno, Takehiro; Misaki, Kouichi; Futami, Kazuya; Nambu, Iku; Yoshikawa, Akifumi; Kamide, Tomoya; Nakada, Mitsutoshi
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_320
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Bleb formation is a rupture risk in unruptured intracranial aneurysms. Although hemodynamic factors influencing bleb formation have been studied using computational fluid dynamics (CFD) analysis, robust causative factors remain unclear. Previous CFD studies have analyzed the hemodynamics of aneurysm models before bleb formation (actual prebleb model in this study) or manually bleb-removal aneurysm models (virtual prebleb model). The morphological difference between these two models and the aneurysm just before bleb formation may mislead the results of the CFD analysis. METHODS: Based on three-dimensional computed tomographic angiography (3D CTA) data of two unruptured aneurysms with de novo bleb formation, three models: an actual prebleb model, a postbleb model, and a virtual prebleb model, were created and subjected to CFD analysis. RESULTS: The bleb occurred in the region where the major intra-aneurysmal flow changed the direction with decreasing velocity. The regions of bleb formation were associated with high pressure, low wall shear stress, divergent wall shear stress vectors, and partially high oscillatory shear index. The CFD analyses for both actual and virtual prebleb models showed the same results. CONCLUSION: De novo bleb formation may be associated with high pressure and divergent wall shear stress vectors. Both actual and virtual prebleb models were suggested to be reliable for CFD analysis of bleb formation.