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Modeling of the Acute Effects of Primary Hypertension and Hypotension on the Hemodynamics of Intracranial Aneurysms

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Abstract

Hemodynamics is a risk factor in intracranial aneurysms (IA). Hypertension and pharmacologically induced hypotension are common in IA patients. This study investigates how hypertension and hypotension may influence aneurysmal hemodynamics. Images of 23 IAs at typical locations were used to build patient-specific Computational Fluid Dynamics models. The effects of hypotension and hypertension were simulated through boundary conditions by modulating the normotensive flow and pressure waveforms, in turn produced by a 1D systemic vascular model. Aneurysm location and flow pattern types were used to categorize the influence of hypotension and hypertension on relevant flow variables (velocity, pressure and wall shear stress). Results indicate that, compared to other locations, vertebrobasilar aneurysms (VBA) are more sensitive to flow changes. In VBAs, space-averaged velocity at peak systole increased by 30% in hypertension (16–21% in other locations). Flow in VBAs in hypotension decreased by 20% (10–13% in other locations). Momentum-driven hemodynamic types were also more affected by hypotension and hypertension, than shear-driven types. This study shows how patient-specific modeling can be effectively used to identify location-specific flow patterns in a clinically-relevant study, thus reinforcing the role played by modeling technologies in furthering our understanding of cardiovascular disease, and their potential in future healthcare.

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Abbreviations

IA:

Intracranial aneurysm

CFD:

Computational fluid dynamics

3DRA:

Three-dimensional rotational angiography

ICA:

Internal carotid artery

MCA:

Middle cerebral artery

PCOM:

Posterior communicating artery

VBA:

Vertebrobasilar artery

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

MD:

Momentum-driven

SD:

Shear-driven

MV:

Maximum velocity at peak systole

SavV:

Space-averaged velocity at peak systole

MTavV:

Maximum time-averaged velocity

TavV:

Time-averaged velocity

STavV:

Space-and-time-averaged velocity

WSS:

Wall shear stress

TavWSS:

Time-averaged wall shear stress

STavWSS:

Space-and-time-averaged wall shear stress

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Acknowledgments

The research leading to these results has received funding from the European Union’s Sixth (FP6/2002-2006) and Seventh Framework Programme (FP7/2007–2013) under grant agreements  no. FP6-IST- 027703 (@neurIST), no. FP7-ICT-601055 (VPH-DARE@IT), and no. FP7-ICT-69978 (VPH-Share). The authors would also like to acknowledge the computational support provided by the Department of Chemical Engineering, Isfahan University of Technology (IUT).

Author information

Authors and Affiliations

  1. Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran

    Ali Sarrami-Foroushani & Mohsen Nasr Esfahany

  2. Center for Computational Imaging and Simulation Technologies in Biomedicine, Department of Mechanical Engineering, University of Sheffield, C14 - Engineering Graduate School Building, Pam Liversidge Building, Mappin Street, Sheffield, S1 3JD, UK

    Maria-Cruz Villa-Uriol, Luigi Yuri Di Marco & Alejandro F. Frangi

  3. Department of Neuroradiology, Royal Hallamshire Hospital, Sheffield, UK

    Stuart C. Coley

  4. Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK

    Alberto Marzo

Authors
  1. Ali Sarrami-Foroushani
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  2. Maria-Cruz Villa-Uriol
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  3. Mohsen Nasr Esfahany
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  4. Stuart C. Coley
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  5. Luigi Yuri Di Marco
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  6. Alejandro F. Frangi
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  7. Alberto Marzo
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Corresponding author

Correspondence to Maria-Cruz Villa-Uriol.

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Associate Editor Umberto Morbiducci oversaw the review of this article.

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Sarrami-Foroushani, A., Villa-Uriol, MC., Nasr Esfahany, M. et al. Modeling of the Acute Effects of Primary Hypertension and Hypotension on the Hemodynamics of Intracranial Aneurysms. Ann Biomed Eng 43, 207–221 (2015). https://doi.org/10.1007/s10439-014-1076-7

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  • DOI: https://doi.org/10.1007/s10439-014-1076-7

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