A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side?
Background: Saccular aneurysms (SAs) have been long studied in hemodynamics using computational fluid dynamics (CFD), while dissecting aneurysms (DAs) remain unclear. To estimate which side of the aneurysm ruptured, we evaluated the hemodynamics of the bilateral vertebral artery DAs (VADAs).Case pre...
| 出版年: | Brain Hemorrhages |
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| 主要な著者: | , , , , , , , , , |
| フォーマット: | 論文 |
| 言語: | 英語 |
| 出版事項: |
KeAi Communications Co., Ltd.
2025-02-01
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| 主題: | |
| オンライン･アクセス: | http://www.sciencedirect.com/science/article/pii/S2589238X24000330 |
| _version_ | 1849505356155191296 |
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| author | Masanori Tsuji Fujimaro Ishida Ryuta Yasuda Tomonori Ichikawa Takenori Sato Kazuhiro Furukawa Yoichi Miura Yasuyuki Umeda Naoki Toma Hidenori Suzuki |
| author_facet | Masanori Tsuji Fujimaro Ishida Ryuta Yasuda Tomonori Ichikawa Takenori Sato Kazuhiro Furukawa Yoichi Miura Yasuyuki Umeda Naoki Toma Hidenori Suzuki |
| author_sort | Masanori Tsuji |
| collection | DOAJ |
| container_title | Brain Hemorrhages |
| description | Background: Saccular aneurysms (SAs) have been long studied in hemodynamics using computational fluid dynamics (CFD), while dissecting aneurysms (DAs) remain unclear. To estimate which side of the aneurysm ruptured, we evaluated the hemodynamics of the bilateral vertebral artery DAs (VADAs).Case presentation: A 44-year-old male was diagnosed with subarachnoid hemorrhage by the rupture of either side of bilateral VADAs. The rupture side could not be determined on admission (Day 0). CFD was performed using a patient-specific geometry model obtained from 3-demensional (3D) rotational angiography (RA) on day 1. We predicted that the right DA had ruptured based on the hemodynamics, associated with flow stagnation and complexity in the ruptured SAs by a transient analysis with the patient-specific blood flow velocity waveforms. After careful observation, gadolinium-enhanced MRI on day 16 showed a contrast effect in the right wall and a change in the right shape was confirmed on the second 3D RA on day 17. According to both imaging evaluations and CFD, the right was presumed to be ruptured, and a flow-diverter stent was placed at the right VA. The right VADA did not re-rupture for 12 months.Conclusion: Our results indicated that hemodynamics of ruptured DAs would be similar to that of ruptured SAs. |
| format | Article |
| id | doaj-art-e54de2473a7042bc88d3d439f36753eb |
| institution | Directory of Open Access Journals |
| issn | 2589-238X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | KeAi Communications Co., Ltd. |
| record_format | Article |
| spelling | doaj-art-e54de2473a7042bc88d3d439f36753eb2025-08-20T03:00:59ZengKeAi Communications Co., Ltd.Brain Hemorrhages2589-238X2025-02-0161576010.1016/j.hest.2024.04.006A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side?Masanori Tsuji0Fujimaro Ishida1Ryuta Yasuda2Tomonori Ichikawa3Takenori Sato4Kazuhiro Furukawa5Yoichi Miura6Yasuyuki Umeda7Naoki Toma8Hidenori Suzuki9Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan; Corresponding author at: Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, JapanDepartment of Neurosurgery, Mie Chuo Medical Center, National Hospital Organization, Tsu, Mie, JapanDepartment of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, JapanDepartment of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, JapanDepartment of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, JapanHisai Neurosurgical Clinic, Tsu, Mie, JapanDepartment of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, JapanDepartment of Neurosurgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, JapanDepartment of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, JapanDepartment of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, JapanBackground: Saccular aneurysms (SAs) have been long studied in hemodynamics using computational fluid dynamics (CFD), while dissecting aneurysms (DAs) remain unclear. To estimate which side of the aneurysm ruptured, we evaluated the hemodynamics of the bilateral vertebral artery DAs (VADAs).Case presentation: A 44-year-old male was diagnosed with subarachnoid hemorrhage by the rupture of either side of bilateral VADAs. The rupture side could not be determined on admission (Day 0). CFD was performed using a patient-specific geometry model obtained from 3-demensional (3D) rotational angiography (RA) on day 1. We predicted that the right DA had ruptured based on the hemodynamics, associated with flow stagnation and complexity in the ruptured SAs by a transient analysis with the patient-specific blood flow velocity waveforms. After careful observation, gadolinium-enhanced MRI on day 16 showed a contrast effect in the right wall and a change in the right shape was confirmed on the second 3D RA on day 17. According to both imaging evaluations and CFD, the right was presumed to be ruptured, and a flow-diverter stent was placed at the right VA. The right VADA did not re-rupture for 12 months.Conclusion: Our results indicated that hemodynamics of ruptured DAs would be similar to that of ruptured SAs.http://www.sciencedirect.com/science/article/pii/S2589238X24000330Computational fluid dynamicsRupture statusBilateral vertebral artery dissecting aneurysms |
| spellingShingle | Masanori Tsuji Fujimaro Ishida Ryuta Yasuda Tomonori Ichikawa Takenori Sato Kazuhiro Furukawa Yoichi Miura Yasuyuki Umeda Naoki Toma Hidenori Suzuki A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side? Computational fluid dynamics Rupture status Bilateral vertebral artery dissecting aneurysms |
| title | A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side? |
| title_full | A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side? |
| title_fullStr | A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side? |
| title_full_unstemmed | A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side? |
| title_short | A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side? |
| title_sort | case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics which is the rupture side |
| topic | Computational fluid dynamics Rupture status Bilateral vertebral artery dissecting aneurysms |
| url | http://www.sciencedirect.com/science/article/pii/S2589238X24000330 |
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