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Published on: June 3, 2021
Hemodynamic Differences in Intracranial Aneurysms before and after Rupture
B M W Cornelissen1, J J Schneiders2, W V Potters2
1From the MIRA Institute for Biomedical Engineering and Technical Medicine (B.M.W.C., C.H.S.), University of Twente, Enschede, the Netherlands Departments of Radiology (B.M.W.C., J.J.S., W.V.P., R.v.d.B., C.B.L.M.M., H.A.M.) Biomedical Engineering and Physics (B.M.W.C, E.V., H.A.M.), Academic Medical Center, Amsterdam, the Netherlands b.m.cornelissen@amc.uva.nl.
Intracranial aneurysm hemodynamics can change due to geometric alterations near rupture. This finding suggests caution when interpreting studies comparing ruptured and unruptured aneurysms based solely on hemodynamics.
Area of Science:
- Neurosurgery
- Medical Imaging
- Computational Fluid Dynamics
Background:
- Intracranial aneurysm rupture risk is linked to hemodynamics.
- Previous studies compared hemodynamics of ruptured vs. unruptured aneurysms.
- Aneurysm geometry may change around rupture, altering hemodynamics.
Purpose of the Study:
- To assess changes in intracranial aneurysm hemodynamics.
- To investigate hemodynamic alterations due to geometric changes before, during, or after rupture.
Main Methods:
- 3D imaging (MRA, CTA, 3D rotational angiography) used before and after rupture.
- Geometric models of aneurysms and vasculature generated.
- Computational fluid dynamics (CFD) simulated intra-aneurysmal hemodynamics.
- Flow complexity, stability, inflow concentration, and impingement qualitatively assessed.
Main Results:
- Hemodynamics changed in 6 out of 9 aneurysms.
- Observed changes included flow complexity, stability, inflow concentration, and impingement.
- Changes were associated with aneurysm displacement, growth, or new lobulations due to rupture.
Conclusions:
- Geometric changes can alter intracranial aneurysm hemodynamics.
- Findings suggest caution when interpreting hemodynamic associations with rupture from case-control studies.
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