Hemodynamic Analysis Of The Middle Cerebral Artery Bifurcation Aneurysm And After It Incompletely Clipped

Objective:To observe the hemodynamic characteristics of aneurysm which located middle cerebral artery bifurcation area and after it incompletely clipped by three-dimension computer numerical simulation method.Participant:One inpatient from Department of Neurosurgery, The First Hospital Affiliated to Jilin University was selected at 2009.10.Patient, Female,69-year-old with right middle cerebral artery bifurcation aneurysm.Methods:Aneurysm numerical model was constructed by three-dimensional computed tomography,and reconstructed at CATIA software. The images were transform to IGS file which further introduced into Gambit software to modify and obtain the three-D meshes of aneurysms.Then the computational fluid dynamics software was used to simulate the blood flow and analyze the hydrodynamics.Result:The hemodynamic of Middle cerebral artery bifurcation aneurysm is similar to the other area aneurysm。Its flow distribution is showed to be a small part blood fluid from inlet artery flowing into aneurysm,and a large part blood fluid directly flowing into outlet arteries caused by turbulent flow of the aneurysm neck area.the blood fluid coming from inlet artery flow by complicated way in the aneurysm and finally come out of aneurysm and flow into outlet arteries.At the aneurysm dome area,the blood fluid velocity is slow,the press is low and the wall shear stress is almost 0. At the aneurysm neck area,the blood fluid velocity is fast,the press and the wall shear stress is high.With clipping the aneurysm neck area aggravation, the blood fluid velocity,the press and the wall shear stress is increased at the aneurysm neck area. at the aneurysm dome area the press is also increased, but the degree is smaller than the aneurysm neck area.the blood fluid velocity and the wall shear stress of the aneurysm dome almost don't change.Conclution: 1.At the aneurysm dome area,the blood fluid velocity is slow,the press is low and the wall shear stress is almost 0,Therefore the the aneurysm dome area is likely to rupture. At the aneurysm neck area,the blood fluid velocity is fast,the press and the wall shear stress is high,Therefore the aneurysm neck is the area to make aneurysm growing and enlarging.2. Middle cerebral artery bifurcation aneurysm should be completely clippted, or the treatment may be not effective,even it is possible to make the aneurysm growing.