Computational fluid dynamics analysis on recurrence of simple coiling intracranial aneurysms with remnant neck
Tóm tắt
Hemodynamic factors are considered to play an important role in the initiation and recurrence of cerebral aneurysms. However, hemodynamic characteristics leading to the recurrence of aneurysms is not well recognized. This study analyzes the hemodynamics of simple-coiling and remnant-neck aneurysms, and discusses the impact of hemodynamic factors on the recurrence of cerebral aneurysms. This study selected three simple-coiled and remnant-neck aneurysms with at least once angiographic follow-up. The follow-up was conducted by 3D rotational DSA and the 3D reconstruction of the vessel. The aneurysms located on ophthalmic segment of ICA, including one recurrent case and two stable cases. We used a porous medium model to simulate and analyze the hemodynamics of aneurysms. For the recanalized aneurysm, in the immediate post-operative period, the WSS at the remnant neck decreased, low blood flow velocity and stagnant regions were found in the aneurysm sac. In the first follow-up, compared to immediately post-operative, at the residual neck, the WSS was higher, the flow impingement was stronger. In the sac, the stagnation area decreased and its contour limit shrank into the aneurysm. However, in the second follow-up, compared to the previous follow-up, at the remnant neck, the WSS was lower, the flow impingement weaker, while in the sac the stagnant region expanded. Aneurysm recurrence could occur in two phases: early coil compaction resulting from blood flow impingement and later vessel remodeling due to hemodynamic effects.
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Nohra C, Cory D. Long-term catheter angiography after aneurysm coil therapy: results of 209 patients and predictors of delayed recurrence and retreatment. J Neurosurg. 2014;121:1102–6.
Kai Y, Hamada J, Kuratsu J, et al. Evaluation of the stability of small ruptured aneurysms with a small neck after embolization with Guglielmi detachable coils: Correlation between coil packing ratio and coil compaction. Neurosurgery. 2005;56:785–92.
Jin S-C, Kwon O-K, Park H, et al. Simple coiling using single or multiple catheters without balloons or stents in middle cerebral artery bifurcation aneurysms. Neuroradiology. 2013;55:321–6.
Gallas S, Pasco A, Cottier JP, et al. A multicenter study of 705 ruptured intracranial aneurysms treated with guglielmi detachable coils. AJNR Am J Neuroradiol. 2005;26:1723–31.
Shengzhang Wang*, Jialiang Chen, Xiaolong Zhang, et al. Non-newtonian computational hemodynamics in two patient-specific cerebral aneurysms with daughter saccules. J Hydrodynamics. 2010;22:639–646.
Lu G, Zhang XL, Geng DY, et al. Influence of hemodynamic factor on rupture of intracranial aneurysm: patient-specific 3d mirror aneurysms model computational fluid dynamics simulation. AJNR Am J Neuroradiol. 2011;32:1255–61.
Chatziprodromou I, Tricoli A, Poulikakos D, Ventikos Y. Haemodynamics and wall remodelling of a growing cerebral aneurysm: a computational model. J Biomech. 2007;40:412–26.
Low M, Perktold K, Raunig R. Hemodynamics in rigid and distensible saccular aneurysms: a numerical study of pulsatile flow characteristics. Biorheology. 1993;30:287–98.
Jou LD, Wong G, Dispensa B, et al. Correlation between luminal geometry changes and hemodynamics in fusiform intracranial aneurysms. AJNR Am J Neuroradiol. 2005;26:2357–63.
Acevedo-Bolton G, Jou LD, Dispensa BP, et al. Estimating the hemodynamic impact of interventional treatments of aneurysms: numerical simulation with experimental validation: technical case report. Neurosurgery. 2006;59:E429–30.
Sugiyama SI, Meng H, Funamoto K, et al. Hemodynamic analysis of growing intracranial aneurysms arising from a posterior inferior cerebellar artery. World Neurosurg. 2012;78:462–68.
Shojima M, Oshima M, Takagi K, et al. Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of20 middle cerebral artery aneurysms. Stroke. 2004;35:2500–5.
Ford MD, Nikolov HN, Milner JS, et al. Piv-measured versus CFD-predicted flow dynamics in anatomically realistic cerebral aneurysm models. J Biomech Eng. 2008;130:210–15.
Sluzewski M, Rooij W, Slob M, et al. Relation between aneurysm volume, packing and compaction in 145 cerebral aneurysms treated with coils. Radiology. 2004;231:653–8.
Hasan DM, Nadareyshvili AI, Hoppe AL, et al. Cerebral aneurysm sac growth as the etiology of recurrence after successful coil embolization. Stroke. 2012;43:86–868.
Luo B, Yang X, Wang S, et al. High shear stress and flow velocity in partially occluded aneurysms prone to recanalization. Stroke. 2011;42:745–53.
Kakalis NMP, Mitsos AP, Byrne JV, et al. The haemodynamics of endovascular aneurysm treatment: A computational modeling approach for estimating the influence of multiple coil deployment. IEEE Transmed Imaging. 2008;27:814–24.
Choi DS, Kim MC, Terbrugge KG, et al. Clinical and angiographic long-term follow-up of completely coiled intracranial aneurysms using endovascular technique. J Neurosurg. 2010;112:575–81.
Mitsos AP, Kakalis NMP, Ventikos YP, et al. Haemodynamic simulation of aneurysm coiling in an anatomically accurate computational fluid dynamics model: Technical note. Neuroradiology. 2008;50:341–7.
Keiko I, Hitomi A, Naomi H, et al. Computational fluid dynamic analysis following recurrence of cerebral aneurysm after coil embolization. AJNS. 2012;7:109–15.