Key result
Simulated exercise increases peak aneurysmal wall shear stress by ~26% in computational modeling.
Why the study?
Do exercise-induced variations in heart rate and internal carotid artery flow rate alter intra-aneurysmal wall shear stress and pressure in a patient-specific computational model of a ruptured ICA aneurysm?
Do exercise-induced variations in heart rate and internal carotid artery flow rate alter intra-aneurysmal wall shear stress and pressure in a patient-specific computational model of a ruptured ICA aneurysm?
Patient-specific CFD modeling demonstrates that increasing blood flow and heart rate during exercise can produce non-linear, counterintuitive changes in intra-aneurysmal wall shear stress areas, highlighting the influence of individual vascular geometry on aneurysm hemodynamics.
Answers are grounded in this paper and cite their sources.
Exercise-induced WSS changes appear geometry-dependent in this model; hypothesis-generating and should not yet alter activity guidance.
BACKGROUND: Hemodynamics is thought to play an important role in the mechanisms responsible for initiation, growth, and rupture of intracranial aneurysms. Computational fluid dynamic (CFD) analysis is used to assess intra-aneurysmal hemodynamics. OBJECTIVES: This study aimed to investigate the effects of variations in heart rate and internal carotid artery (ICA) flow rate on intra-aneurysmal hemodynamics, in an ICA aneurysm, by using computational fluid dynamics. PATIENTS AND METHODS: Computed tomography angiography (CTA) was performed in a 55 years old female case, with a saccular ICA aneurysm, to create a patient-specific geometrical anatomic model of the aneurysm. The intra-aneurysmal hemodynamic environments for three states with different flow and heart rates were analyzed using patient-specific image-based CFD modeling. RESULTS: Results showed significant changes for the three simulated states. For a proportion of the states examined, results were counterintuitive. Systolic and time-averaged wall shear stress and pressure on the aneurysm wall showed a proportional evolution with the mainstream flow rate. CONCLUSION: Results reinforced the pivotal role of vascular geometry, with respect to hemodynamics, together with the importance of performing patient-specific CFD analyses, through which the effect of different blood flow conditions on the aneurysm hemodynamics could be evaluated.
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Sarrami‐Foroushani et al. (2015) studied Ruptured saccular internal carotid artery (ICA) aneurysm (n=1). Simulated exercise-induced variations in heart rate (93 and 127 bpm) and ICA flow rate (+11.6% and +18.4%) via computational fluid dynamics vs. Resting state simulation (heart rate 60 bpm, baseline ICA flow rate) was evaluated on Space and time-averaged wall shear stress (WSS) and time-averaged maximum WSS on the aneurysmal wall. Simulated exercise states increased time-averaged maximum wall shear stress by up to 26.4%, though space- and time-averaged WSS decreased by 4.4% at the highest flow state.
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