Correlation Between Aneurysm Size and Hemodynamics in One Individual with Multiple Small Intracranial Aneurysms.

Liangder Jou,Dr Gavin Britz

doi:10.7759/cureus.683

Abstract

ObjectiveA large number of cases are needed in the patient-specific modeling of intracranial aneurysms to establish the statistical significance due to individual variation of risk factors that are difficult to account for. However, these risk factors are critical in hemorrhage risk as demonstrated in large clinical studies. Rupture risks for aneurysms in an individual are easier to compare because these aneurysms are under the same physiological environment, and their only differences are the local hemodynamic factors associated with their anatomic locations.MethodsEight small aneurysms (< 7 mm) from one individual were analyzed using patient-specific hemodynamic modeling. Four scenarios with different perfusion assumptions were performed to account for the flow rate at two smaller communicating arteries. Wall shear stresses (WSS) at these aneurysms were compared to determine their relationship with the aneurysm size.ResultsEach of the three largest aneurysms is either the most proximal or distal aneurysm in a given artery so that blood pressure does not have a direct influence on aneurysm size. No wall shear stress-derived hemodynamic variables are found to be related to aneurysm size.DiscussionA study of multiple aneurysms from one individual offers a unique opportunity to examine various hemodynamic factors without selection biases. Aneurysms greater than 4 mm (Group 1) have a higher product of maximum WSS and area of low WSS; aneurysms smaller than 4 mm (Group 2) have a lower product of maximum WSS and area of low WSS. In addition, aneurysm size is linearly correlated with the flow rate at the parent artery in each group.

Highlights

How to cite this article Jou L, Britz G (July 12, 2016) Correlation Between Aneurysm Size and Hemodynamics in One Individual with Multiple Small Intracranial Aneurysms
No wall shear stress-derived hemodynamic variables are found to be related to aneurysm size
Patient-specific aneurysm modeling allows us to assess the hemodynamic influences on rupture risk of aneurysms that cannot be accomplished in simplified idealized geometry [4], and results of these analyses permit an examination of various hypotheses on the role of wall shear stress (WSS) in the formation, growth, and rupture of aneurysms [5]

Summary

Introduction

How to cite this article Jou L, Britz G (July 12, 2016) Correlation Between Aneurysm Size and Hemodynamics in One Individual with Multiple Small Intracranial Aneurysms. Hemodynamics plays an important role in the formation, growth, and rupture of intracranial aneurysms [1,2,3]. Patient-specific aneurysm modeling allows us to assess the hemodynamic influences on rupture risk of aneurysms that cannot be accomplished in simplified idealized geometry [4], and results of these analyses permit an examination of various hypotheses on the role of wall shear stress (WSS) in the formation, growth, and rupture of aneurysms [5]. A hemodynamic analysis of growing aneurysms can reveal the conditions that predispose aneurysms for growth [6]; a comparison of hemodynamic variables between ruptured and unruptured aneurysms provides an insight on the level and pattern of WSS leading to rupture [7,8]. Other hemodynamic variables have been studied [8, 12,13]

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Discussion

Conclusion