Skip to main content
SpringerLink
Log in

In vivo study of flow pattern at human carotid bifurcation with regard to aneurysm development

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

In order to investigate the developmental mechanism of cerebral aneurysms, the in vivo flow pattern around human cervical carotid bifurcations was studied by flow visualization using digital subtraction angiography with an isotonic contrast medium.

The blood stream containing the medium impinged on the apex, then proceeded along the walls of the branches. After opacification of the whole lumen around the apex, most of the medium was carried away, while some remained for a few seconds at the carotid sinus. In the internal carotid artery, the blood struck the wall at an oblique angle near the tops of the arterial curvatures. In cases with atheromatous plaque or kinking of the branch, the blood passed through the stenosed segment and moved upstream, indicating turbulence.

The study suggests that haemodynamic forces around the apex consist mainly of impingement on the apex and shear stress to the wall at and around the apex. In branches, high shear stress seems to exist. It might be possible that high shear stress causes degenerative changes in the endothelial layer, initiating the formation of saccular and fusiform cerebral aneurysms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anderson DC, Fischer GG (1985) Impact of digital subtraction angiography on carotid evaluation. Stroke 16: 23–28

    PubMed  Google Scholar 

  2. Bharadvaj BK, Mabon RF, Giddens DP (1982) Steady flow in a model of the human carotid bifurcation. Part 1. Flow visualization. J Biomech 15: 349–362

    PubMed  Google Scholar 

  3. Duff TA, Turski PA, Sackett JF, Strother CM, Crummy AB (1982) Evolving role of digital subtraction angiography in neurosurgical practice. Neurosurgery 11: 430–438

    PubMed  Google Scholar 

  4. Ferguson GG (1972) Physical factors in the initiation, growth, and rupture of human intracranial saccular aneurysms. J Neurosurg 37: 666–677

    PubMed  Google Scholar 

  5. Ferguson GG (1970) Turbulence in human intracranial saccular aneurysms. J Neurosurg 33: 485–497

    PubMed  Google Scholar 

  6. Forbus WD (1930) On the origin of miliary aneurysms of the superficial cerebral arteries. Bull Johns Hopkins Hosp 47: 239–284

    Google Scholar 

  7. Fry DL (1968) Acute vascular endothelial changes associated with increased blood velocity gradients. Circ Res 22: 165–197

    PubMed  Google Scholar 

  8. Gessner FB (1973) Hemodynamic theories of atherogenesis. Circ Res 3: 259–266

    Google Scholar 

  9. Hashimoto N, Handa H, Hazama F (1978) Experimentally induced cerebral aneurysms in rats. Surg Neurol 10: 3–8

    PubMed  Google Scholar 

  10. Hashimoto N, Handa H, Nagata I, Hazama F (1980) Experimentally induced cerebral aneurysms in rats. Part V: Relation of hemodynamics in the circle of Willis to formation of aneurysms. Surg Neurol 13: 41–45

    PubMed  Google Scholar 

  11. Hassler O (1961) Morphological studies on the large cerebral arteries. With reference to the aetiology of subarachnoid haemorrhage. Acta Psychiatr Neurol Scand [Suppl] 36: 1–145

    Google Scholar 

  12. Hazama F, Amano S, Haebara H, Yamori Y, Okamoto K (1976) Pathology and pathogenesis of cerebrovascular lesions in Spontaneous hypertensive rats. In: Cervós-Navarro J, Matakas F (eds) The cerebral vessel wall. New York, Raven Press, pp 245–252

    Google Scholar 

  13. Hazama F, Hashimoto N (1987) Annotation. An animal model of cerebral aneurysms. Neuropathol Appl Neurobiol 13: 77–90

    PubMed  Google Scholar 

  14. Hazama F, Kataoka H, Yamada E, Kayembe K, Hashimoto N, Kojima M, Kim Ch (1986) Early changes of experimentally induced cerebral aneurysms in rats. Light-microscopic study. Am J Pathol 124: 399–404

    PubMed  Google Scholar 

  15. Kayembe KT, Sasahara M, Hazama F (1984) Cerebral aneurysms and variations in the circle of Willis. Stroke 15: 846–850

    PubMed  Google Scholar 

  16. Kim Ch, Kikuchi H, Hashimoto N, Hazama F (1990) Angiographic study of induced cerebral aneurysms in primates. Neurosurgery 27: 715–720

    PubMed  Google Scholar 

  17. Kim Ch, Kikuchi H, Hashimoto N, Hazama F (1989) Histopathological study of induced cerebral aneurysms in primates. Surg Neurol 32: 45–50

    PubMed  Google Scholar 

  18. Kim Ch, Kikuchi H, Hashimoto N, Hazama F, Kataoka H (1989) Establishment of the experimental conditions for inducing saccular cerebral aneurysms in primates with special reference to hypertension. Acta Neurochir (Wien) 96: 132–136

    Google Scholar 

  19. Kim Ch, Kikuchi H, Hashimoto N, Kojima M, Kang Y, Hazama F (1988) Involvement of internal elastic lamina in development of induced cerebral aneurysms in rats. Stroke 19: 507–511

    PubMed  Google Scholar 

  20. Kojima M, Handa H, Hashimoto N, Kim Ch, Hazama F (1986) Early changes of experimentally induced cerebral aneurysms in rats: Scanning electron microscopic study. Stroke 17: 835–841

    PubMed  Google Scholar 

  21. Ku DN, Giddens DP (1983) Pulsatile flow in a model carotid bifurcation. Arteriosclerosis 3: 31–39

    PubMed  Google Scholar 

  22. Liepsch DW, Steiger HJ, Poll A, Reulen HJ (1987) Hemodynamic stress in lateral saccular aneurysms. Biorheology 24: 689–710

    PubMed  Google Scholar 

  23. LoGerfo FW, Nowak MD, Quist WC (1985) Structural details of boundary layer separation in a model human carotid bifurcation under steady and pulsatile flow conditions. J Vasc Surg 2: 263–269

    PubMed  Google Scholar 

  24. Ludwig JW, Verhoeven LHJ, Engels PHC (1982) Digital video subtraction angiography (DSA) equipment. Angiographic technique in comparison with conventional angiography in different vascular areas. Br J Radiol 55: 545–553

    PubMed  Google Scholar 

  25. Matsuda I, Niimi H, Moritake K, Okumura A, Handa H (1978) The role of hemodynamic factors in arterial wall thickening in the rat. Atherosclerosis 29: 363–371

    PubMed  Google Scholar 

  26. Micholls SC, Phillips DJ, Primozich JF, Lawrence RL, Kohler TR, Rudd TG, Strandness DE (1989) Diagnostic significance of flow separation in the carotid bulb. Stroke 20: 175–182

    PubMed  Google Scholar 

  27. Motomiya M, Karino T (1984) Flow patterns in the human carotid artery bifurcation. Stroke 15: 50–56

    PubMed  Google Scholar 

  28. Nakatani H, Hashimoto N, Kang Y, Yamazoe N, Kikuchi H, Yamaguchi S, Niimi H (1991) Flow patterns at major bifurcations and cerebral aneurysms in rats. J Neurosurg 74: 258–262

    PubMed  Google Scholar 

  29. Robinson JL, Roberts A (1972) Operative treatment of aneurysms and Coanda effect: a working hypothesis. J Neurol Neurosurg Psychiatry 35: 804–809

    PubMed  Google Scholar 

  30. Seeger J, Weinstein PR, Carmony RF, Ovitt TW, Fisher HD, Capp MP (1982) Digital video subtraction angiography of the cervical and cerebral vasculature. J Neurosurg 56: 173–179

    PubMed  Google Scholar 

  31. Sekhar LN, Heros RC (1981) Origin, growth, and rupture of saccular aneurysms: A review. Neurosurgery 8: 246–260

    Google Scholar 

  32. Steiger HJ, Reulen H-J (1986) Low frequency flow fluctuations in saccular aneurysms. Acta Neurochir (Wien) 83: 131–137

    Google Scholar 

  33. Steiger HJ, Pöll A, Liepsch D, Reulen H-J (1987) Haemodynamic stress in lateral saccular aneurysms. Acta Neurochir (Wien) 86: 98–105

    Google Scholar 

  34. Steiger HJ, Aaslid R, Reulen H-J (1989) Growth of aneurysms can be understood as passive yield to blood pressure. An experimental study. Acta Neurochir (Wien) 100: 74–78

    Google Scholar 

  35. Wolinsky H, Goldfischer S, Schiller B, Kasak LE (1974) Modification of the effects of hypertension on lysosomes and connective tissue in the rat aorta. Circ Res 34: 233–241

    PubMed  Google Scholar 

  36. Wright HP (1968) Endothelial mitosis around aortic branches in normal guinea pigs. Nature 220: 78–79

    PubMed  Google Scholar 

  37. Yaşargil MD (1987) Pathological conditions. In: Yaşargil MD (ed) Microneurosurgery, Vol 1. Thieme Medical Publishers, New York, pp 279–349

    Google Scholar 

  38. Zarins CK, Giddens DP, Bharadvaj BK, Sottiurai VS, Mabon RF, Glagov S (1983) Carotid bifurcation atherosclerosis. Quantitative correlation of plaque localization with flow velocity profiles and wall shear stress. Circ Res 53: 502–514

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Fukui Red Cross Hospital, Fukui, Japan

    Y. Tokuriki, Y. Takebe & K. Hori

  2. Institute of Neuropathology, Free University of Berlin, Berlin, Germany

    Ch. Kim M.D., J. Cervós-Navarro, C. Pätzold, Y. Tokuriki, Y. Takebe & K. Hori

Authors
  1. Ch. Kim M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Cervós-Navarro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Pätzold
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y. Tokuriki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. Takebe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. Hori
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported by grant from the Alexander von Humboldt Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, C., Cervós-Navarro, J., Pätzold, C. et al. In vivo study of flow pattern at human carotid bifurcation with regard to aneurysm development. Acta neurochir 115, 112–117 (1992). https://doi.org/10.1007/BF01406368

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01406368

Keywords

Search

Navigation