The objective of this study was to use image-based computational fluid dynamics (CFD) techniques to analyze the impact that multiple closely spaced intracranial aneurysm (IAs) of the supra-clinoid segment of the internal carotid artery (ICA) have on each other's hemodynamic characteristics. The vascular geometry of fifteen (15) subjects with 2 IAs was gathered using a 3D digital subtraction angiography clinical system. Two groups of computer models were created for each subject's vascular geometry: both IAs present (model A) and after removal of one IA (model B). Models were separated into two groups based on IA separation: tandem (one proximal and one distal) and adjacent (aneurysms directly opposite on a vessel). Simulations using a pulsatile velocity waveform were solved by a commercial CFD solver. Proximal IAs altered flow into distal IAs (5 of 7), increasing flow energy and spatial-temporally averaged wall shear stress (STA-WSS: 3–50% comparing models A to B) while decreasing flow stability within distal IAs. Thus, proximal IAs may “protect” a distal aneurysm from destructive remodeling due to flow stagnation. Among adjacent IAs, the presence of both IAs decreased each other's flow characteristics, lowering WSS (models A to B) and increasing flow stability: all changes statistically significant (p < 0.05). A negative relationship exists between the mean percent change in flow stability in relation to adjacent IA volume and ostium area. Closely spaced IAs impact hemodynamic alterations onto each other concerning flow energy, stressors, and stability. Understanding these alterations (especially after surgical repair of one IA) may help uncover risk factor(s) pertaining to the growth of (remaining) IAs.
Two Closely Spaced Aneurysms of the Supraclinoid Internal Carotid Artery: How Does One Influence the Other?
Michigan Technological University,
Houghton, MI 49931
Second Military Medical University,
Shanghai 200433, China
School of Medicine and Public Health,
University of Wisconsin,
Madison, WI 53705
Manuscript received September 5, 2017; final manuscript received May 24, 2019; published online July 30, 2019. Assoc. Editor: Alison Marsden.
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Sunderland, K., Huang, Q., Strother, C., and Jiang, J. (July 30, 2019). "Two Closely Spaced Aneurysms of the Supraclinoid Internal Carotid Artery: How Does One Influence the Other?." ASME. J Biomech Eng. November 2019; 141(11): 114501. doi: https://doi.org/10.1115/1.4043868
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