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Vol. 30. Issue 5.
Pages 207-214 (September - October 2019)
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Vol. 30. Issue 5.
Pages 207-214 (September - October 2019)
Clinical Research
DOI: 10.1016/j.neucie.2019.04.001
A1 asynchrony, a potential risk factor for the rupture of anterior communicating artery aneurysms: A computational fluid dynamics study
Asincronía de A1, un factor de riesgo potencial para la rotura de aneurismas de la arteria comunicante anterior: un estudio de dinámica de fluidos computacional
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Josèc) Luis Thenier-Villaa,b,c,
Corresponding author
, Antonio Riveiro Rodríguezd, Rosa María Martínez-Rolána,c, Miguel Gelabert-Gonzálezb, Pedro Miguel González-Vargasa, Lourdes Calero-Fèc)lixa, Raúl Alejandro Galarraga Campoverdea,c, Adolfo Ramón De La Lama Zaragozaa,c, Juan Poud, Cesáreo Conde Alonsoa,c
a Department of Neurosurgery, University Hospital Complex of Vigo, Estrada de Clara Campoamor, 341, Vigo 36312, Spain
b Department of Surgery, University of Santiago de Compostela, Rúa de San Francisco, s/n, 15782 Santiago de Compostela, Spain
c Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, Estrada de Clara Campoamor, 341, Vigo 36312, Spain
d Applied Physics Department, EEI, University of Vigo, Lagoas-Marcosende, s/n, Vigo 36310, Spain
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Figures (2)
Tables (3)
Table 1. Baseline characteristics of the population.
Table 2. Geometric characteristics of the arteries studied.
Table 3. Univariate analysis of low shear area changes in relation to geometric characteristics.
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Abstract
Introduction and objectives

The anterior communicating complex is one the most common locations for aneurysm development. It receives blood from both carotid circulations and the effect of synchrony on the arrival of blood flow has not been previously studied. The objective of this study was to compare the asynchrony conditions of the A1 pulse and its effects on the haemodynamic conditions of anterior communicating artery (ACoA) aneurysms.

Materials and methods

From 2008 to 2017, 54 anterior communicating artery aneurysms treated at our centre were included in the study. Computational fluid dynamics (CFD) techniques were employed and simulations consisted of complete conditions of synchrony and introducing a delay of 0.2s in the non-dominant A1 artery. Time-averaged wall shear stress (TAWSS), low shear area (LSA), A1 diameter and ACoA angles were measured.

Results

The difference in the LSA in conditions of synchrony and asynchrony resulted in a broad range of positive and negative values. The symmetry index (p=0.04) and A1/A2 angle on the dominant artery (p=0.04) were associated with changes in LSA.

Conclusions

In asynchrony, LSA increased in the absence of A1 asymmetry and low A1/A2 angles, potentially increasing the risk of aneurysm rupture in this location.

Keywords:
Anterior communicating artery aneurysm
Subarachnoid haemorrhage
Computational fluid dynamics
Asynchrony
Brain aneurysm
Resumen
Introducción y objetivos

El complejo comunicante anterior es una de las localizaciones más frecuentes para el desarrollo de aneurismas; recibe sangre de ambas circulaciones carotídeas y el efecto de la sincronía en la llegada de sangre no ha sido estudiado previamente. El objetivo de este estudio es comparar las condiciones de asincronía del pulso de A1 y sus efectos en las condiciones hemodinámicas de los aneurismas de la arteria comunicante anterior (ACoA).

Materiales y mèc)todos

Desde 2008 hasta 2017, 54 aneurismas de la ACoA tratados en nuestro centro se incluyeron en el estudio. Se emplearon tèc)cnicas de dinámica de fluidos computacional y las simulaciones consistieron en condiciones de completa sincronía y en la introducción de un retraso de 0,2s en la arteria A1 no dominante. Se realizaron mediciones del TAWSS, área de bajo cizallamiento (LSA), diámetros de A1 y ángulos de la AcoA.

Resultados

La diferencia producida en el LSA en condiciones de sincronía y asincronía resultó en un amplio rango de valores positivos y negativos. El índice de simetría (p=0,04) y el ángulo A1/A2 en la arteria dominante (p=0,04) se relacionan con los cambios en el LSA.

Conclusiones

En asincronía, el LSA se incrementó en ausencia de asimetría A1 y ángulos A1/A2 menores, incrementando potencialmente el riesgo de rotura de aneurismas en esta localización.

Palabras clave:
Aneurisma de la arteria comunicante anterior
Hemorragia subaracnoidea
Dinámica de fluidos computacional
Asincronía
Aneurisma cerebral

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