Document Detail

Hemodynamics and bleb formation in intracranial aneurysms.
MedLine Citation:
PMID:  19797790     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Intracranial aneurysms with irregular shapes and blebs or secondary outpouchings have been correlated with increased rupture risk. The purpose of this study was to investigate possible associations between the local hemodynamics and the formation of blebs in cerebral aneurysms.
MATERIALS AND METHODS: Computational models of 20 cerebral aneurysms harboring 30 well-defined blebs were constructed from 3D rotational angiographies. Models representing the aneurysm before bleb formation were constructed by virtually removing the blebs from the anatomic models. Computational fluid dynamics simulations of the aneurysm before and after bleb formation were performed under pulsatile flows. Flow and WSS visualizations were used to analyze the local hemodynamics in the region of the aneurysm that developed the bleb.
RESULTS: Most blebs (80%) occurred at or adjacent to the aneurysm region with the highest WSS before bleb formation, and near the flow impaction zone. Most blebs (83%) were found in regions of the aneurysm previously subjected to high or moderate WSS and progressed to low WSS states after the blebs were formed. Most blebs (77%) were aligned or adjacent to the inflow jet, whereas 17% were aligned with the outflow jet, and only 6% were not aligned with the flow direction. In addition, 90% of the aneurysms had maximal WSS higher than or similar to the WSS in the parent artery.
CONCLUSIONS: Blebs form at or adjacent to regions of high WSS and are aligned with major intra-aneurysmal flow structures. Formation of blebs results in a lower WSS state with formation of a counter current vortex. These findings imply that locally elevated WSS could contribute to the focalized wall damage that formed these structures.
J R Cebral; M Sheridan; C M Putman
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-10-01
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-04-23     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  304-10     Citation Subset:  IM    
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MeSH Terms
Cerebral Angiography
Cerebral Arteries / physiopathology*,  radiography
Cerebrovascular Circulation / physiology*
Databases, Factual
Hemodynamics / physiology*
Intracranial Aneurysm / epidemiology,  physiopathology*,  radiography
Models, Cardiovascular*
Regional Blood Flow / physiology
Risk Factors
Stress, Mechanical
Systole / physiology
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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