Influence of relative residence time on side-wall aneurysm inception

Document Type

Article

Publication Date

9-1-2018

Abstract

Background: Relative residence time (RRT) is amarker of disturbed blood flow, marked by lowmagnitude and high oscillatory wall shear stress (WSS). The relation between solute residence time in proximity to the vascular endothelium and the atherosclerotic process is well appreciated in the literature. Objective: To assess the influence of RRT on side-wall aneurysm inception to better understand the role of atherosclerosis in aneurysm formation. Methods: Fourteen side-wall internal carotid artery aneurysms fromthe Aneurisk repository which met criteria for parent vessel reconstruction were reconstructed with Vascular Modeling Toolkit. Computational fluid dynamics analysis was carried out in Fluent. RRT was calculated in MATLAB (The MathWorks Inc, Natick, Massachusetts). We analyzed the results for correlations, defined as presence or absence of local elevations in RRT in specific regions of vasculature. Results: RRT was concluded to be negatively correlated with aneurysm inception in this study of side-wall internal carotid artery aneurysms, with 12/14 cases yielding the absence of local RRT elevationswithin or in close proximity of the removed ostium. Subsequent analysis of WSS showed that 11 of 14 aneurysms were formed in an atheroprotective environment, with only 1 of 14 formed in an atherogenic environment. Two models were found to be of indeterminate environment. Conclusion: Atherogenesis and atherosclerosis have long been thought to be a major inciting factor responsible for the formation of aneurysms in the cerebral vasculature. We propose that inception of side-wall aneurysms occurs in hemodynamic environments that promote an atheroprotective endothelial phenotype and that the atheroprotective phenotype is therefore aneurysmogenic.

Identifier

85055206473 (Scopus)

Publication Title

Clinical Neurosurgery

External Full Text Location

https://doi.org/10.1093/neuros/nyx433

e-ISSN

15244040

ISSN

0148396X

PubMed ID

28945849

First Page

574

Last Page

581

Issue

3

Volume

83

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