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Central nervous system
Published in David A Lisle, Imaging for Students, 2012
Most cerebral artery aneurysms are congenital ‘berry’ aneurysms. Berry aneurysms occur in 2 per cent of the population and are multiple in 10 per cent of cases. Increased incidence of berry aneurysms occurs in association with coarctation of the aorta and autosomal dominant polycystic kidney disease. Most berry aneurysms occur around the circle of Willis, the most common sites being:Anterior communicating arteryPosterior communicating arteryMiddle cerebral arteryBifurcation of internal carotid arteryTip of basilar artery.
Glossary of scientific and technical terms in bioengineering and biological engineering
Published in Megh R. Goyal, Scientific and Technical Terms in Bioengineering and Biological Engineering, 2018
Artery, Anterior Cerebral (ACA) passes anteromedially via the horizontal plane to enter the interheimispheric fissure, anastomoses with the contralateral ACA via the anterior communicating artery forming the anterior portion of the circle of Willis.
Extraction of patient-specific boundary conditions from 4D-DSA and their influence on CFD simulations of cerebral aneurysms
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Yuya Uchiyama, Soichiro Fujimura, Hiroyuki Takao, Hiroshi Ono, Keigo Katayama, Takashi Suzuki, Toshihiro Ishibashi, Katharina Otani, Kostadin Karagiozov, Koji Fukudome, Yuichi Murayama, Makoto Yamamoto
This study was approved by the Ethics Committee of the Jikei University School of Medicine. Two neurosurgeons independently, blindly, and randomly selected one patient each as the subjects of the study. The subjects were selected from the departmental database of aneurysms in the anterior circulation with 4D-DSA image acquisition. The first patient had a cerebral aneurysm of the anterior communicating artery (Case A) and the second of the internal carotid artery (ICA) (Case B). The patients were females aged 72 years (Case A) and 83 years (Case B) at the time of image acquisition. We established the geometries of their arteries using Amira and then calculated the centreline using VMTK. It should be noted that we calculated the centreline only of the parent artery without including any brunches and aneurysmal sac because these geometries show a different diameter and may lead to inaccurate extraction. We conducted two CFD simulation patterns to access the haemodynamic difference caused by the patient-specific inflow conditions. The first was named as a general pattern and we imposed an unscaled waveform obtained from Karmonik et al. (2008) as the inflow condition. The unscaled waveform has a 0.8-second pulse cycle duration, and its maximum and minimum velocities are 0.2 and 0.1 m/s, respectively. The second was named as a patient-specific pattern, in which the waveform was scaled based on the extracted velocities and pulse cycle duration. We calculated two-pulse-cycle flow under these conditions. The simulations parameters are provided in the Supplemental Material.
Braided stents and their impact in intracranial aneurysm treatment for distal locations: from flow diverters to low profile stents
Published in Expert Review of Medical Devices, 2019
Christina Iosif, Alessandra Biondi
Distally located intracranial aneurysms refer to the ones located at or distally to the Willis; they account for 5–10% of all intracranial aneurysms [1]. Most of them arise from the middle cerebral artery and anterior cerebral artery distal to the anterior communicating artery [1,2]. The traditionally considered gold standard treatment for distal aneurysms, microsurgical clipping, is associated with high occlusion rates, but also with increased mortality and morbidity rates [1,3]; in some cases clipped aneurysms may recur [4]. For these cases, existing adhesions and anatomic complexity are issues to consider for microsurgical retreatment [4]. Recent bibliographic data showed good outcomes with FDs in aneurysm recurrences after surgical clipping [5,6].
An update on intrasaccular flow disruption for the treatment of intracranial aneurysms
Published in Expert Review of Medical Devices, 2019
Matthias Gawlitza, Sébastien Soize, Pierre-François Manceau, Laurent Pierot
The typical indication for treatment with a WEB device is an unruptured wide-neck bifurcation aneurysm located at the level of the middle cerebral artery (MCA), anterior communicating artery (AcomA), basilar artery (BA) or internal carotid artery terminus (ICAt). An illustrative case in shown in Figure 2.