2023 Volume 51 Issue 5 Pages 405-410
Objective: The relationship between the aneurysm wall characteristics and local hemodynamics remains unexplored. Thin, red aneurysm walls observed under microsurgical conditions indicate fragility associated with the risk of aneurysm rupture. In contrast, atherosclerotic lesions on the aneurysm wall caused by hyperplastic remodeling pose a risk of incomplete obliteration during neck clipping. In this study, we aimed to elucidate the relationship between hemodynamic parameters determined using computational fluid dynamics (CFD) and aneurysm wall characteristics. Such insights may provide valuable information for making decision in the treatment of intracranial aneurysms.
Methods: In this retrospective study, 45 unruptured saccular intracranial aneurysms were examined using intraoperative video recordings and steady-state analysis. The relationship between aneurysm wall characteristics, examined under an operative microscope, and hemodynamic properties, examined using CFD, were analyzed.
Results: Among the observed findings, 15 out of 18 regions with coexistence of low normalized wall shear stress (NWSS) and collisional wall shear stress (WSS) vectors demonstrated hyperplastic remodeling. In contrast, 26 out of 36 regions with a high NWSS exhibited thin, red aneurysm walls. In addition, 17 out of 21 regions with concurrent high NWSS and parallel WSS vectors exhibited destructive remodeling.
Conclusion: CFD demonstrated the ability to predict aneurysm wall characteristics based on the hemodynamic features in a clinical setting, and it may allow for optimal decision making in the treatment of unruptured intracranial aneurysms.
