Intra-aneurysmal hemodynamics in a large middle cerebral artery aneurysm with wall atherosclerosis

• Published in: Surgical neurology 2008-11, Vol.70 (5), p.454-462
• Main Authors: Tateshima, Satoshi, MD, Tanishita, Kazuo, PhD, Omura, Hiroyoshi, MS, Sayre, James, PhD, Villablanca, J. Pablo, MD, Martin, Neil, MD, Vinuela, Fernando, MD
• Format: Article
• Language: English
• Subjects: Atherosclerosis; Blood Flow Velocity - physiology; Cerebral aneurysm; Cerebrovascular Circulation - physiology; Hemodynamics; Humans; Intracranial Aneurysm - complications; Intracranial Aneurysm - pathology; Intracranial Aneurysm - physiopathology; Intracranial Arteriosclerosis - complications; Intracranial Arteriosclerosis - pathology; Intracranial Arteriosclerosis - physiopathology; Laser-Doppler Flowmetry; Models, Cardiovascular; Models, Neurological; Neurology; Remodeling; Surgery; Vascular Resistance - physiology; Wall shear stress
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/j.surneu.2008.03.035

Abstract Background The remodeling of arterial extra-cellular matrix induced by hemodynamic stimuli is involved in the process of atherosclerosis in the carotid and cerebral arteries. Scarce information is available on the relationship between atherosclerotic changes in brain aneurysms itself and its intra-aneurysmal hemodynamics. Methods Surgical exploration of a large MCA aneurysm depicted extensive atherosclerotic changes in the aneurysm wall. Computational tomographic angiography of this aneurysm was used to create an in vitro aneurysm model. This model was used to perform intra-aneurysmal flow measurement using particle imaging velocimetry and LDV. Intra-aneurysmal hemodynamic pattern with wall shear stress distribution was compared between areas with and without atherosclerotic changes. Results No high oscillation of wall shear stress was observed on the atherosclerotic plaque area. However, the magnitude of wall shear stress tended to be higher in the area without atherosclerotic changes than the area with those changes ( P < .001). There was no atherosclerotic change at the aneurysm inflow zone, where relatively fast flow velocity and higher magnitude of wall shear stress was noted. Conclusions This single case of atherosclerosis in an aneurysm shows some similarity in hemodynamic values observed in cases of carotid atherosclerotic plaques.