effects of variations of flow and heart rate on intra-aneurysmal hemodynamics in a ruptured internal carotid artery aneurysm during exercise

Background: hemodynamics is thought to play an important role in the mechanisms responsible for initiation, growth, and rupture of intracranial aneurysms. computational fluid dynamic (cfd) analysis is used to assess intra-aneurysmal hemodynamics. objectives: this study aimed to investigate the effects of variations in heart rate and internal carotid artery (ica) flow rate on intra- aneurysmal hemodynamics, in an ica aneurysm, by using computational fluid dynamics.patients and methods: computed tomography angiography (cta) was performed in a 55 years old female case, with a saccular ica aneurysm, to create a patient-specific geometrical anatomic model of the aneurysm. the intra-aneurysmal hemodynamic environments for three states with different flow and heart rates were analyzed using patient-specific image-based cfd modeling. results: results showed significant changes for the three simulated states. for a proportion of the states examined, results were counterintuitive. systolic and time-averaged wall shear stress and pressure on the aneurysm wall showed a proportional evolution with the mainstream flow rate.conclusion: results reinforced the pivotal role of vascular geometry, with respect to hemodynamics, together with the importance of performing patient-specific cfd analyses, through which the effect of different blood flow conditions on the aneurysm hemodynamics could be evaluated.