Computational fluid dynamics analysis of a carotid-ophthalmic aneurysm with concomitant ophthalmic artery infundibulum in a patient-specific model.

Computational fluid dynamics analysis of a carotid-ophthalmic aneurysm with concomitant ophthalmic artery infundibulum in a patient-specific model.

World Neurosurg. 2019 Feb 13;:

Authors: Ba D, Zhu Z, Yue X, Xu P, Yan P, Xiao D

Abstract
BACKGROUND: Although previous studies have reported cases of coexistence of carotid-ophthalmic aneurysm (COA) and ophthalmic artery (OA) infundibulum, the hemodynamic characteristics of this complicated structure and its damaging effect on vision remain to be elucidated. The aim of this study was to analyze this specific artery structure using computational fluid dynamics (CFD) techniques.
METHODS: We presented a patient diagnosed with COA, who had been suffering from blurred vision. Transient analysis was performed to investigate blood flowing in the parent artery. Hemodynamic parameters such as streamline, wall shear stress, oscillatory shear index, and relative residence time were obtained.
RESULTS: When the inlet velocity of the parent artery was at the second peak, the flow rate and intensity of the vortex reached their maximum. In the aneurysm neck, a region of high TAWSS and a region of low TAWSS with high OSI coexisted; besides, a relaxation area was found. In the aneurysm dome, the minimum TAWSS was 2.5Pa, the maximum OSI was 0.48, and the two regions did not overlap. In the OA infundibulum, the maximum OSI and RRT were 0.47 and 39.2, respectively; the minimum TAWSS was 0.59Pa.
CONCLUSIONS: We detected aneurysm regions that were susceptible to further expansion and assessed the rupture risk of each region; the relaxation area could promote aneurysm progression. Besides, the location of the vortex shear force center varied with time. In addition, double vortex streamlines influenced blood supply through the OA, thus impairing vision; infundibulum may promote thrombus formation and hence retard OA blood flow.

PMID: 30771545 [PubMed - as supplied by publisher]

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