The use of Computational Fluid Dynamics in solving the mystery of origin of Cerebral Aneurysms
Joint Event on 12th International Conference on Vascular Dementia and Dementia & 8th International Conference on Neurological Disorders and Stroke
March 14-16, 2019 | London, UK
Henan Provincial People’s Hospital, China
Posters & Accepted Abstracts : J Brain Neurol
To investigate the mechanisms of cerebral aneurysms and the effect of treatment modalities on the genesis of cerebral aneurysms. Seven hundred and twenty four patients with cerebral aneurysms were investigated in the locations of the cerebral aneurysms using the angiographic data. The angiographic data of 140 patients with cerebral aneurysms were processed for computational fluid dynamics (CFD). Different modalities including stent-assisted coiling, coiling alone, stenting alone, single stenting, Y-configuration stenting, and surgical clipping were analyzed for their effects on the mechanisms of CFD. Results: A total of 1018 cerebral aneurysms were detected in these patients. Seven hundred and seventeen aneurysms involved a branch, accounting for 70.4% of all the aneurysms, with the most populous places being the intracranial internal carotid artery (ICA) segments (23.9%), the anterior cerebral artery (17.9%), the middle cerebral artery (17.8%), and the posterior circulation (9.3%). 301 aneurysms were located on a vascular curve (29.6%), with the most populous site being the ICA (25.4%), the intracranial vertebral artery (2.2%), and the distal cerebral arteries (1.5%). Not a single aneurysm was found on a straight segment of vessel. CFD analysis showed some common features that, on the wall where a cerebral aneurysm was generated, two peak values and one minimal value were demonstrated on the curve of wall shear stress while one peak value was revealed on the total pressure curve. Conclusion: Cerebral aneurysms are initiated at sites with both high wall shear stress and total pressure, and stenting especially Y-shaped stenting can decrease the hemodynamic stresses for aneurysm initiation while coiling alone or surgical clipping do not. Stenting with Y configuration is a better choice of treatment than coiling or surgical clipping in managing the genesis of cerebral aneurysms.