2024-03-29T15:42:09Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00028739
2023-11-16T02:59:09Z
499:508:509:2445
Factors influencing blood flow resistance from a large internal carotid artery aneurysm revealed by a computational fluid dynamics model
Imai, Tasuku
94432
Izumi, Takashi
94433
Isoda, Haruo
94434
Ishiguro, Kenta
94435
Mizuno, Takashi
94436
Tsukada, Tetsuya
94437
Kropp, Asuka
94438
Ito, Masashi
94439
Nishihori, Masahiro
94440
Ishida, Mamoru
94441
Tamari, Yosuke
94442
Wakabayashi, Toshihiko
94443
large internal carotid artery aneurysm
computational fluid dynamics
pressure loss
2019-11
Hyperperfusion syndrome occurs after treatment of a large or giant cerebral aneurysm. Recently, flow-diverter stent placement has emerged as an effective treatment method for a large cerebral aneurysm, but postoperative ipsilateral delayed intraparenchymal hemorrhage occurs in a minority of cases. The mechanism underlying delayed intraparenchymal hemorrhage is not established, but one possibility is hyperperfusion syndrome. The incidence of delayed intraparenchymal hemorrhage appears to be higher for giant aneurysms; hence, we speculated that large/giant aneurysms may create flow resistance, and mitigation by flow-diverter stent deployment leads to hyperperfusion syndrome and delayed intraparenchymal hemorrhage. The purpose of this study was to identify aneurysm characteristics promoting flow resistance by the analysis of pressure loss in an internal carotid artery paraclinoid aneurysm model using computational fluid dynamics. A virtual U-shaped model of the internal carotid artery siphon portion was created with a spherical aneurysm of various angles, body diameters, and neck diameters. Visualization of streamlines, were calculated of pressure loss between proximal and distal sides of the aneurysm, and vorticity within the aneurysm were calculated. The pressure loss and vorticity demonstrated similar changes according to angle, peaking at 60°. In contrast, aneurysm diameter had little influence on pressure loss. Larger neck width, however, increases pressure loss. Our model predicts that aneurysm location and neck diameter can increase the flow resistance from a large internal carotid artery aneurysm. Patients with large aneurysm angles and neck diameters may be at increased risk of hyperperfusion syndrome and ensuing delayed intraparenchymal hemorrhage following flow-diverter stent treatment.
departmental bulletin paper
Nagoya University Graduate School of Medicine, School of Medicine
2019-11
Nagoya Journal of Medical Science
4
81
629
636
2186-3326
0027-7622
eng
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/814.html
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International