Variations of Middle Cerebral Artery Hemodynamics Due to Aneurysm Clipping Surgery

Abstract

Cerebral aneurysms are potentially life-threatening cerebrovascular conditions where a weakened blood vessel in the brain bulges or protrudes over time. The most common way to treat aneurysms is surgical clipping, an approach where blood flow to the aneurysm is blocked by a permanently placed clip on the artery. However, not all aneurysms are identical; thus, there has been a need for patient-specific treatment options, where each aneurysm is treated based on its individual characteristics. Computational fluid dynamics (CFD) modeling can offer insights to predict how different treatment procedures will affect cerebral hemodynamics. In that regard, the goal of this pilot study was to investigate the flow characteristics and hemodynamic parameters in cerebral arteries before and after neurosurgical clipping. For this purpose, two patient-specific cerebral artery geometries with at least one aneurysm at the middle cerebral artery bifurcation were selected from an online dataset. A companion post-clipping model was created for each geometry by removing the aneurysm from the original geometry. Tetrahedral mesh elements were then generated and CFD simulations were conducted to compare the blood velocity profile, secondary flow, flow streamline, and wall shear stress in the computational models with and without aneurysm. Results showed that the clipping treatment led to changes in the velocity profiles, secondary flow structures, and wall shear stress in the middle cerebral artery. In conclusion, our results suggest that CFD modeling can assist in predicting hemodynamic parameters prior to treatment, thus facilitating more tailored planning for each patient's treatment.