Intra-aneurysmal pressure was studied in an experimental model of saccular aneurysm in dogs, using a vein pouch grafted onto a common carotid arterial bifurcation. The mean and the pulse pressures were recorded simultaneously from within the aneurysm and within the common carotid artery, before and after 50% proximal carotid artery stenosis. These experiments were performed under systemic normotension, hypotension, and hypertension. Normal data suggest that mean intracarotid and intra-aneurysmal pressures are similar and relate in a nearly linear fashion to mean arterial pressure. However, after 50% stenosis, the data had a cubic relationship, the reduction of pressure occurring only in the middle range of mean arterial pressure. Both intra-aneurysmal and intracarotid pulse pressures displayed less dependence on mean arterial pressure. However, sigmoid curves also were observed with the pulse pressures after 50% proximal common carotid artery stenosis. In all cases, after 50% stenosis, the rate of increase of the pulse pressures with mean arterial pressure was greater for higher mean arterial pressures. Our preliminary data indicate that a detailed study of intra-aneurysmal pressure and blood flow in relation to systemic variables such as mean arterial pressure, cardiac output, and peripheral resistance may not only suggest improved means of managing patients with intracranial aneurysms, but also may raise the possibility that, under certain conditions, higher intraaneurysmal pressures may be induced by downstream stenosis.
- Cerebral aneurysms