• Kornelia M Kliś, Dominika Wójtowicz, Borys M Kwinta, Krzysztof Stachura, Tadeusz J Popiela, Maciej J Frączek, Bartłomiej Łasocha, Jerzy Gąsowski, Olga Milczarek, and Roger M Krzyżewski.
• Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland. Electronic address: kornelia.klis@uj.edu.pl.
• World Neurosurg. 2023 Dec 1; 180: e69e76e69-e76.

BackgroundTortuosity of intracranial arteries has been proven to be associated with the risk of intracranial aneurysm development. We decided to analyze which aspects of tortuosity are correlated with hemodynamics parameters promoting intracranial aneurysm development.MethodsWe constructed 73 idealized models of tortuous artery (length: 25 mm, diameter: 2.5 mm) with single bifurcation. For each model, on the course of segment before bifurcation, we placed 1-3 angles with measures 15, 30, 45, 60, or 75 degrees and arc lengths 2, 5, 7, 10, or 15 mm. We performed computational fluid dynamics analysis. Blood was modeled as Newtonian fluid. We have set velocity wave of 2 cardiac cycles. After performing simulation we calculated following hemodynamic parameters at the bifurcation: time average wall shear stress (TAWSS), time average wall shear stress gradient (TAWSSG), oscillatory shear index (OSI), and relative residence time (RRT).ResultsWe found a significant positive correlation with number of angles and TAWSS (R = 0.329; P < 0.01), TAWSSG (R = 0.317; P < 0.01), and negative with RRT (R = -0.335; P < 0.0.01). Similar results were obtained in terms of arcs lengths. On the other hand, mean angle measure was negatively correlated to TAWSS (R = -0.333; P < 0.01), TAWSSG (R = -0.473 P < 0.01), OSI (R = -0.463; P < 0.01), and positively to RRT (R = 0.332; P < 0.01). On the basis of the obtained results, we developed new tortuosity descriptor, which considered angle measures normalized to its arc length and distance from bifurcation. For such descriptor we found strong negative correlation with TAWSS (R = -0.701; P < 0.01), TAWSSG (R = 0.778; P < 0.01), OSI (R = -0.776; P < 0.01), and positive with RRT (R = 0.747; P < 0.01).ConclusionsHemodynamic parameters promoting aneurysm development are correlated with larger number of smaller angles located on larger arcs.Copyright © 2023 Elsevier Inc. All rights reserved.

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