Haemodynamic stress in terminal aneurysms

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Abstract
The flow velocities in glass and silastic aneurysm models located at bifurcations were quantitatively determined using the non-invasive laser-Doppler method. The geometrical relation between aneurysm and parent vessels was found to be the primary factor governing the intra-aneurysmal flow pattern. Flow was stagnant in straight terminal models, with the aneurysm forming an extension of the afferent vessel, as long as the outflow through the branches of the bifurcation was balanced. Average flow velocities in the fundus were small but turbulent flow fluctuations of high amplitudes were observed. Asymmetric outflow through the branches of the bifurcation induced a rotatory intra-aneurysmal circulation from the dominant to the subordinate branch. The circulation in angled terminal aneurysms with the aneurysmal axis at a 45 degree angle to the plane of the bifurcation was a vortex, which was a natural consequence of the excentric inflow from the afferent vessel. Maximum flow velocities measured in the centre plane of the angled terminal aneurysms were in the range of 50 to 80% of the axial velocity in the afferent vessel. The elasticity of the models did not affect the global turnover rates but it damped the intra-aneurysmal pulse wave. On the basis of the measured velocity gradients near the walls maximum shear stresses on the wall of human terminal aneurysms were estimated to be in the order of 50 dynes/cm2 (5 Pascal), a value that is similar to the maximum wall shear stresses estimated for lateral aneurysms.