Numerical simulation study of hemodynamics of the recurrent intracranial aneurysms after endovascular treatment

Objective: To investigate the role of hemodynamics in the recurrent intracranial aneurysms after endovascular treatment. Methods: Ten patients with recurrent intracranial aneurysm and 10 with non-recurrent aneurysm were selected in the Department of Neurosurgery, Changhai Hospital, the Second Military Medical University from 2006 to October 2009 by matching the conditions of site, size and shape of the aneurysms. A numerical simulation method was used to analyze the aneurysm necks in both groups including the hemodynamic characteristics of wall shear stress, pressure and blood flow velocity. Results: The median (range) of the wall shear stress at the proximal, central and distal parts of aneurysm neck in the recurrent aneurysm group was 3.19 (0.92-22.73), 3.19 (1.04-23.01) and 5.03 (1.88-23.06) Pa, respectively. The wall shear stress at the distal parts of aneurysm neck was significantly higher than that at the central and proximal parts. There were significant differences among the 3 portions (P = 0.002). The wall shear stress of the 3 corresponding portions in the non-recurrent aneurysm group was 5.61 (0.96-9.59), 5.55 (4.56-7.88) and 5.88 (4.06-10.75), respectively. There were no significant differences. There were no significant differences in the blood flow velocity and pressure of the proximal, central and distal of portions aneurysm neck between the recurrent aneurysm group and the non-recurrent aneurysm group. Conclusion: The local high wall shear stress was associated with the aneurysmal recurrence after endovascular treatment of aneurysms.