Hemodynamic characteristics at anterior communicating artery before aneurysm initiation using patient-specific finite element blood flow simulations

Abstract

The anterior communicating artery (AComA) is a unique vascular location that receives blood from two sources of inflow and redistributes it toward the anterior part of the brain through two efferent arteries. It is widely accepted that complexity in the flow pattern is associated with the high rate of aneurysm formation in that location observed in large studies. A previous computational hemodynamic study showed a possible association between high maximum intraaneurysmal wall shear stress (WSS) at the systolic peak with rupture in a cohort of AComA aneurysms. In another study it was observed a connection between location of aneurysm blebs and regions of high WSS in models where blebs were virtually removed. The purpose of this work is to study associations between hemodynamic patterns and AComA aneurysm initiation by comparing hemodynamics between the aneurysm models and the normal model where the aneurysm was computationally removed. Vascular models of both right and left circulation were independently reconstructed from three-dimensional rotational angiography images using deformable models after image registration of both images, and later fused using a surface merging algorithm. Afterwards, the geometric models were used to generate high-quality volumetric finite element grids composed several million tetrahedral elements with an advancing front technique. For each patient the second anatomical model was created by digitally removing the aneurysm. It was iteratively achieved by applying a Laplacian smoothing filter and remeshing the surface. Finite element blood flow numerical simulations were performed for both the pathological and normal models under the same flow conditions. Personalized pulsatile flow conditions were imposed at the inlets of both models with use of the Womersley solution. The Navier-Stokes equations were numerically integrated by using a fully implicit finite-element formulation. From analysis of WSS distributions it was observed that aneurysms initiated in regions of high and moderate WSS in the counterpart normal models. Adjacent or close to those regions, low WSS portions of the arterial wall were not affected by the disease. These results are in line with previous reported observations at other vascular locations.