Hemodynamic Numerical Simulation Of Paraclinoidal Aneurysms

Objective: Hemodynamics factors are commonly related to the rupture and development of intracranial aneurysms,morphology and hemodynamics play an important role in the rupture and recurrent aneurysms.To investigate the hemodynamic features before and after embolization of paraclinoidal aneurysms using hemodynamic numerical simulation and the influence on the recurrence after embolization.Methods:From January 2016 to December 2016,a total of 56 consecutive patients with paraclinoidal aneurysms treated with embolization at the Department of Neurosurgery,Yijishan Hosptial of Wannan Medical College were enrolled in the study.They were divided into either a recurrent group(n=10)or a stable group(n=46)according to the follow up results.An aneurysm model was induced based on three—dimensional cerebral angiography data before and after embolization.The hemodynamic features around the aneurysm neck areas before and after embolization were analyzed with the finite element algorithm via computational fluid dynamics software,and its influence on the recurrence of aneurysmls was evaluated(range from 3 to 18 month,the median was 6 month).Results: The peak systolic wall shear stress(WSS),oscillatory shear index(OSI)and blood flow velocity around the aneurysm neck areas in the recurrent group before embolization were(20.30±3.13)Pa,(0.06±0.02)and(0.07±0.04)m/s respectively.and they were(23.35±4.56)Pa,(0.07±0.01)and(0.11±0.02)m/s respectively in the stable group.There were no significant differences between the two groups(P value >0.05).The peak systolic WSS,OSI and blood flow velocity around the same areas in the recurrent group after embolization were(35.60±8.75)Pa,(0.07±0.02)and(0.14±0.03)m/s respectively.They were significantly higher compared to those before embolization(P value < 0.05).They were(13.33±5.47)Pa,(0.04±0.01)and(0.08±0.02)m/s respectively in the stable group.Compared to those before embolization,they were significantly higher(P value <0.01).The peak systolic WSS,OSI and blood flow velocity around the aneurysm neck areas in the recurrent group were significantly higher than those in the stable group after embolization.Conclusions:The high blood flow velocity and high WSS around the aneurysm neck areas after embolization of paraclinoidal aneurysms may be an important factor of leading to aneurysm recurrence.