Hemodynamic features and recurrence risk analysis of subtotally embolized ophthalmic aneurysms

Objective The present study investigates the hemodynamic features in the residual necks of subtotally embolized ophthalmic aneurysms and their influence on the recurrence after operation.Methods Four ophthalmic aneurysm cases from January 2007 to July 2008 were studied.The aneurysms of the patients had residual necks after being embolized.Three-dimensional cerebral angiography images were taken before and after embolization,and the aneurysm modes were determined based on these images.The hemodynamic features in the residual neck before and after operation and during recurrence were analyzed by using a hydrodynamic software program and the finite-element method.Results The hemodynamic analysis shows that the residual neck had high shear stress and blood flow velocity regions after embolization in all four cases.Out of the four patients,three experienced recurrence,where blood flowed into the tumor cavity coinciding with the high shear stress regions.Conclusions High shear stress and blood flow velocity in the residual neck of embolized ophthalmic aneurysms manifested in the location of recurrence.Thus,hemodynamic factors may have an important role in the recurrence of ophthalmic aneurysms after embolization.