Numerical Analysis on Hemodynamics in Intracranial Aneurysms

Abstract

Brain aneurysms cause almost 500,000 deaths in the world every year. A better understanding of brain aneurysm genesis and rupture may open new opportunities to prevention and treatment. In this study, a part of the cerebral vascular system, the so called circle of Willis including an aneurysm, was analyzed with Computational Fluid Dynamics (CFD). The importance of boundary conditions in an aneurysm simulation was assessed by comparing the results to 7T MRI velocity data, obtained from the Academic Medical Center (AMC) in Amsterdam. Adequate similarities were found in velocity values, together with qualitative agreement in wall shear stress (WSS) values.
We found that in a patient-specific case with an aneurysm, the velocity profile was able to develop to a parabolic profile because of its location; the aneurysm existed far downstream of the circle of Willis. This implies that it is possible to use a cropped arterial system to simulate the aneurysm and to use parabolic inlet velocity profiles for patients with this aneurysm phenotype.
In previous studies, it proved hard to locate the precise location of rupture in an aneurysm. A risk assessment of the rupture location in an aneurysm can be used as a more accurate tool to assess the need for surgery. The aneurysm geometry of the CFD Rupture challenge from 2013 was simulated to predict the location of a rupture site. This rupture location was predicted by combining the following hemodynamic criteria: the time-averaged wall shear stress (WSSTA), oscillatory shear index (OSI) and vortex-saddle point structure during systole with accompanying low pressure values. A sensitivity study was performed on these criteria and a critical threshold for rupture risk was proposed. Based on these criteria it was possible to predict the exact rupture site for two analyzed aneurysm geometries. It is concluded that a CFD model could be used to assess the hemodynamics in intracranial aneurysms. Future research should focus on repeating this study on more patient specific aneurysm geometries to verify this hypothesis further.