Intraaneurysmal flow dynamics study featuring an acrylic aneurysm model manufactured using a computerized tomography angiogram as a mold.

OBJECT To obtain precise flow profiles in patients' aneurysms, the authors developed a new in vitro study method featuring an aneurysm model manufactured using three-dimensional computerized tomography (3D CT) angiography. METHODS A clear acrylic basilar artery (BA) tip aneurysm model manufactured from a patient's 3D CT angiogram was used to analyze flow modifications during one cardiac cycle. Stereolithography was utilized to create the aneurysm model. Three-dimensional flow profiles within the aneurysm model were obtained from velocity measurements by using laser Doppler velocimetry. The aneurysm inflow/outflow zones changed dynamically in their location, size of their cross-sectional area, and also in their shapes over one cardiac cycle. The flow velocity at the inflow zone was 16.8 to 81.9% of the highest axial velocity in the BA with a pulsatility index (PI) of 1.1. The flow velocity at the outflow zone was 16.8 to 34.3% of the highest axial velocity of the BA, with a PI of 0.68. The shear stress along the walls of the aneurysm was calculated from the fluid velocity measured at a distance of 0.5 mm from the wall. The highest value of shear stress was observed at the bleb of the aneurysm. CONCLUSIONS This clear acrylic model of a BA tip aneurysm manufactured using a CT angiogram allowed qualitative and quantitative analysis of its flow during a cardiac cycle. Accumulated knowledge from this type of study may reveal pertinent information about aneurysmal flow dynamics that will help practitioners understand the relationship among anatomy, flow dynamics, and the natural history of aneurysms.

[1]  A. Friedman,et al.  Utility of Three-dimensional Computed Tomographic Angiography for Assessment of Relationships between the Vertebrobasilar System and the Cranial Base , 2001, Neurosurgery.

[2]  G. Duckwiler,et al.  Endovascular Treatment of Basilar Tip Aneurysms Using Guglielmi Detachable Coils: Anatomic and Clinical Outcomes in 73 Patients from a Single Institution , 2000, Neurosurgery.

[3]  T Kirino,et al.  Risk of rupture from incidental cerebral aneurysms. , 2000, Journal of neurosurgery.

[4]  F Viñuela,et al.  Natural history of the neck remnant of a cerebral aneurysm treated with the Guglielmi detachable coil system. , 2000, Journal of neurosurgery.

[5]  W D Heiss,et al.  Ischemic Penumbra: Evidence From Functional Imaging in Man , 2000, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[6]  H. Boecher-Schwarz,et al.  Ex vivo study of the physical effect of coils on pressure and flow dynamics in experimental aneurysms. , 2000, AJNR. American journal of neuroradiology.

[7]  J P Villablanca,et al.  Volume-rendered helical computerized tomography angiography in the detection and characterization of intracranial aneurysms. , 2000, Journal of neurosurgery.

[8]  M. Könönen,et al.  Cerebral Hemodynamics in Human Acute Ischemic Stroke: A Study with Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging and SPECT , 2000, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[9]  K. Nozaki,et al.  Prevention of rat cerebral aneurysm formation by inhibition of nitric oxide synthase. , 2000, Circulation.

[10]  D A Steinman,et al.  Simulated pathline visualization of computed periodic blood flow patterns. , 2000, Journal of biomechanics.

[11]  R. Armonda,et al.  Diagnostic imaging for stroke. , 2000, Clinical neurosurgery.

[12]  C. Kerber,et al.  Flow dynamics in a lethal anterior communicating artery aneurysm. , 1999, AJNR. American journal of neuroradiology.

[13]  K Katada,et al.  Application of three-dimensional CT angiography (3D-CTA) to cerebral aneurysms. , 1999, Surgical neurology.

[14]  N. Wood,et al.  Aspects of fluid dynamics applied to the larger arteries. , 1999, Journal of theoretical biology.

[15]  F. Kajiya,et al.  Effects of size and shape (aspect ratio) on the hemodynamics of saccular aneurysms: a possible index for surgical treatment of intracranial aneurysms. , 1999, Neurosurgery.

[16]  J. Arnal,et al.  Endothelium-derived nitric oxide and vascular physiology and pathology , 1999, Cellular and Molecular Life Sciences CMLS.

[17]  F Viñuela,et al.  Embolization of incidental cerebral aneurysms by using the Guglielmi detachable coil system. , 1998, Journal of neurosurgery.

[18]  H. Drexler,et al.  Endothelial dysfunction in human disease. , 1999, Journal of molecular and cellular cardiology.

[19]  A. Harders,et al.  Clinical utility of magnetic resonance angiography in the evaluation of aneurysms from a neurosurgical point of view. , 1999, Zentralblatt fur Neurochirurgie.

[20]  J R Adler,et al.  Remote-rendered 3D CT angiography (3DCTA) as an intraoperative aid in cerebrovascular neurosurgery. , 1999, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[21]  Didier Martin,et al.  Unruptured intracranial aneurysms--risk of rupture and risks of surgical intervention. , 1998, The New England journal of medicine.

[22]  Y. Trousset,et al.  3D angiography. Clinical interest. First applications in interventional neuroradiology. , 1998, Journal of neuroradiology. Journal de neuroradiologie.

[23]  S. Rossitti Shear Stress in Cerebral Arteries Carrying Saccular Aneurysms , 1998, Acta radiologica.

[24]  H V Ortega,et al.  Computer simulation helps predict cerebral aneurysms. , 1998, Journal of medical engineering & technology.

[25]  W. C. Chang,et al.  LDV measurements in lateral model aneurysms of various sizes , 1997 .

[26]  C. Zarins,et al.  Flow-induced arterial enlargement is inhibited by suppression of nitric oxide synthase activity in vivo. , 1997, Surgery.

[27]  E. M. Pedersen,et al.  Wall shear stress and early atherosclerotic lesions in the abdominal aorta in young adults. , 1997, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[28]  H. Kikuchi,et al.  Cerebral aneurysms arising at nonbranching sites. An experimental Study. , 1997, Stroke.

[29]  S Glagov,et al.  Fluid wall shear stress measurements in a model of the human abdominal aorta: oscillatory behavior and relationship to atherosclerosis. , 1994, Atherosclerosis.

[30]  J. Stamler,et al.  Redox signaling: Nitrosylation and related target interactions of nitric oxide , 1994, Cell.

[31]  S. Juvela,et al.  Natural history of unruptured intracranial aneurysms: a long-term follow-up study. , 1993, Journal of neurosurgery.

[32]  T. Lüscher,et al.  Endothelial regulation of vascular tone and growth. , 1993, American journal of hypertension.

[33]  E. Holme,et al.  Interferon-gamma and tumor necrosis factor synergize to induce nitric oxide production and inhibit mitochondrial respiration in vascular smooth muscle cells. , 1992, Circulation research.

[34]  C M Strother,et al.  Aneurysm hemodynamics: an experimental study. , 1992, AJNR. American journal of neuroradiology.

[35]  Y. Cho,et al.  Intracranial aneurysms: flow analysis of their origin and progression. , 1992, AJNR. American journal of neuroradiology.

[36]  C M Strother,et al.  Flow dynamics of lateral carotid artery aneurysms and their effects on coils and balloons: an experimental study in dogs. , 1992, AJNR. American journal of neuroradiology.

[37]  H. Kikuchi,et al.  Cerebral blood flow patterns at major vessel bifurcations and aneurysms in rats. , 1991, Journal of neurosurgery.

[38]  C W Kerber,et al.  Transparent elastic arterial models. I: A brief technical note. , 1989, Biorheology.

[39]  A Kamiya,et al.  Roles of fluid shear stress in physiological regulation of vascular structure and function. , 1988, Biorheology.

[40]  Y. Fung,et al.  Mechanics of the Circulation , 2011, Developments in Cardiovascular Medicine.

[41]  H. Steiger,et al.  Hemodynamic stress in lateral saccular aneurysms. , 1987 .

[42]  O. Heiskanen Risks of surgery for unruptured intracranial aneurysms. , 1986, Journal of neurosurgery.

[43]  C. Kerber,et al.  Flow in experimental berry aneurysms: method and model. , 1983, AJNR. American journal of neuroradiology.

[44]  G. Hutchins,et al.  Correlation of human arterial morphology with hemodynamic measurements in arterial casts. , 1981, Journal of biomechanical engineering.