Abstract

ABSTRACTIntracranial aneurysm is a pathological dilatation of the cerebral artery which can lead to high mortality rate upon rupture. The aspect ratio (AR) of an aneurysm, being the ratio of the height to neck width, is an important factor in estimating the likelihood of aneurysm rupture in clinical practice. AR will generally increase while the aneurysm grows. Clinical observations over the years show that aneurysms with larger AR usually exhibit higher rupture risk. The goal of the current study is to conduct Fluid-Structure Interaction (FSI) analyses to provide quantitative estimates on the importance of AR, wall thickness (tw) and hypertension. The effects of varying AR and tw on the hemodynamics, wall stress and displacement will be studied based on patient-specific models. Both sidewall and bifurcation aneurysms are investigated. There is a significant increase in the wall stress at the aneurysmal dome (the location in an aneurysm where rupture is commonly observed clinically) when the AR increases and tw decreases due to the aneurysm growth process. Furthermore, these investigations are repeated for patients with hypertension (high blood pressure) conditions. The increase in the wall stress due to hypertension for models with higher ARs is more dramatic. The clinically observed feature of higher rupture risk of aneurysms with larger AR is thus supported quantitatively.

Highlights

  • Abnormal dilation of the artery, termed aneurysm, can be life-threatening

  • A possible explanation is that the ratio of the neck width to the aneurysm height becomes relatively smaller as the aspect ratio (AR) increases, thereby restricting flow from entering the aneurysm

  • The present study should be valuable in providing quantitative data and trends in constituting relations among AR increase, wall thickness reduction due to aneurysm growth, hemodynamic features of the fluid medium, as well as the effective and principal stresses in the aneurysm wall

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Summary

Introduction

Abnormal dilation of the artery, termed aneurysm, can be life-threatening. Rupture of an intracranial aneurysm (IA) can lead to massive internal bleeding in the subarachnoid space. The occurrence rate of IA is 2% to 5% in the population (Humphrey & Taylor, 2008) and aneurysm rupture leads to high mortality rate (Sforza, Putman, & Cebral, 2009). A typical geometric parameter of the aneurysm is the aspect ratio (AR) which is defined as the ratio of the aneurysm height to the equivalent diameter ( = circumference/π ) of the aneurysm neck. Clinical analysis reported that aneurysms with AR greater than 1.6 are prone to rupture (Ujiie, Tamano, Sasaki, & Hori, 2001). Several types of endovascular surgical treatment including coiling and flow diverter stenting are available for mitigating the risk of rupture

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