title: Patient-specific computational fluid dynamics modeling of anterior communicating artery aneurysms: a study of the sensitivity of intra-aneurysmal flow patterns to flow conditions in the carotid arteries.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effects of unequal physiologic flow conditions in the internal carotid arteries (ICAs) on the hemodynamics of anterior communicating artery aneurysms.
  
  
  METHODS
  Patient-specific computational fluid dynamics models of 2 cerebral aneurysms were constructed from bilateral 3D rotational angiograms. The flow dynamics of the aneurysm sac were analyzed under the effect of unequal mean flows, phase shifts, and waveforms between the ICAs. A total of 9 simulations were performed for each patient; cine flow velocity simulations and unsteady wall shear stress (WSS) maps were created for each flow condition. Time-dependent curves of average WSS magnitude over selected regions on the aneurysms were constructed.
  
  
  RESULTS
  Mean flow unbalances in the feeding vessels tended to shift the regions of elevated WSS towards the dominating inflow jet and to change the magnitude of the WSS peaks. The overall qualitative appearance of the WSS distribution and velocity simulations was not substantially affected. Phase and waveform asymmetry increased the temporal complexity of the hemodynamic patterns and tended to destabilize the flow pattern.
  
  
  CONCLUSIONS
  Differences in the relative phase and waveform shape in ICAs can significantly affect the complexity and stability of the hemodynamic force distributions. The magnitude of these effects is related to the geometry of the aneurysm and the feeding vessels. Conditions affecting the flow characteristics in the parent arteries of cerebral aneurysms with more than 1 avenue of inflow should be incorporated into flow models.
authors.affiliation: College of Sciences, Department of Computational and Data Sciences, George Mason University, Fairfax, VA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Castro
authors.forename: C M
authors.initials: CM
authors.lastname: Putman
authors.forename: J R
authors.initials: JR
authors.lastname: Cebral
mesh_terms: D000792:Angiography; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity