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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(04): 764-768
DOI: 10.1055/s-0043-1771367
Original Article

Predicting Morphological Changes to Vessel Walls Adjacent to Unruptured Cerebral Aneurysms Using Computational Fluid Dynamics

Kento Sasaki 
1   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Fuminari Komatsu 
1   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Kyosuke Miyatani
1   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Riki Tanaka
1   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Yasuhiro Yamada
1   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Yoko Kato
1   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Yuichi Hirose
2   Department of Neurosurgery, Fujita Health University, Toyoake, Aichi, Japan
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Abstract

Objective This study compared intraoperative findings with preoperative computed tomography angiography (CTA) and computational fluid dynamics (CFD) analysis of perianeurysmal findings for the indication of possible vessel wall thinning.

Materials and Methods Participants comprised 38 patients with unruptured middle cerebral artery aneurysms treated by surgical clipping at our hospital between May 2020 and April 2021. We defined parent artery radiation sign (PARS) as the presence of each of the following three findings in CFD analysis based on preoperative CTA: (1) impingement of the stream line on the outer parent vessel wall of the aneurysm; (2) radiation of wall shear stress vectors outwards from the same site; and (3) increased wall pressure compared with the surrounding area. CFD analysis showing PARS was compared with intraoperative findings.

Results In all nine cases with PARS, no morphological abnormalities were found in the same area on CTA. However, intraoperative findings showed thinning of the parent artery wall in one of the nine cases and formation of a very small mass in three cases, differing from CTA findings. All nine patients underwent additional clipping and/or wrapping and coating at the site of PARS.

Conclusion Detecting thinning of the vessel wall or the presence of a microaneurysm may be difficult in endovascular therapy, which is based on the visualization of the vessel lumen. CFD analysis suggests the necessity of confirming findings for the vessel wall around an aneurysm by direct manipulation, as the presence of PARS may indicate partial thinning of the vessel wall or formation of a microaneurysm.

Keywords

computational fluid dynamics - middle cerebral artery - morphological change - unruptured intracranial aneurysm

Authors' Contributions

K.S. helped in conceptualization, data curation, formal analysis, investigation, methodology, resources, validation, visualization, and writing—original draft. F.K. contributed to methodology, and writing—review and editing. K.M. helped in investigation. R.T. and Y.Y. were involved in methodology and investigation. Y.K. helped in resources and supervision. Y.H. helped in project administration.




Publikationsverlauf

Artikel online veröffentlicht:
15. Dezember 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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