Proximal Parent Vessel Tapering is Associated With Aneurysm at the Middle Cerebral Artery Bifurcation

Neurosurgery
Alexandra LauricAdel M Malek

Abstract

Cerebral aneurysm initiation and evolution have been linked to hemodynamic and morphological factors. Stenotic morphology upstream to a bifurcation can alter hemodynamic patterns and lead to destructive vessel wall remodeling and aneurysm initiation. The effect of more subtle proximal variations in vessel diameter on bifurcation aneurysm development has not been evaluated. To investigate whether vessel tapering is associated with aneurysmal presence at the middle cerebral artery (MCA) bifurcation. Bilateral catheter three-dimensional rotational angiographic datasets from 33 patients with unilateral unruptured MCA aneurysms and 44 datasets from healthy patients were analyzed. Equidistant cross-sectional cuts were generated along the MCA M1 segment with cross-sectional area measurement using edge-detection filtering. Relative tapering of the M1 segment was evaluated as the TaperingRatio. Computational fluid dynamics (CFD) simulations were performed on bilateral patient models and parametric MCAs of constant and tapered inflow vessel. MCA leading to aneurysms had significantly lower TaperingRatio (0.88 ± 0.15) compared to contralateral (1.00 ± 0.16, P = .002) and healthy MCAs (1.00 ± 0.15, P > .001, area under the curve = 0.73), w...Continue Reading

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Citations

Mar 4, 2020·International Journal for Numerical Methods in Biomedical Engineering·Aslak W BergersenKristian Valen-Sendstad
Mar 20, 2019··Henrik KjeldsbergAslak Bergersen

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