Hemodynamic Changes Caused by Multiple Stenting in Vertebral Artery Fusiform Aneurysms: A Patient-Specific Computational Fluid Dynamics Study
| Autor: | Wei Cao, J.-M. Liu, Ignacio Larrabide, Yibin Fang, Nan Lv, Quan Huang, D. Zhu, Christof Karmonik |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty CIENCIAS MÉDICAS Y DE LA SALUD Vertebral artery medicine.medical_treatment 0206 medical engineering Hemodynamics Fusiform Aneurysm 02 engineering and technology Models Biological Biotecnología de la Salud 03 medical and health sciences 0302 clinical medicine Text mining medicine.artery Shear stress Humans Medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Vertebral Artery Aged Aged 80 and over Interventional business.industry Stent Intracranial Aneurysm aneurismas cerebrales Middle Aged simulación de fluidos equipment and supplies medicine.disease 020601 biomedical engineering Thrombosis Intensity (physics) Hydrodynamics Female Stents Stress Mechanical Neurology (clinical) Radiology business 030217 neurology & neurosurgery Otras Biotecnologías de la Salud |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a5452 |
| Popis: | Background and Purpose: The multiple stent placement technique has largely improved the long-term outcomes of intracranial fusiform aneurysms, but the hemodynamic mechanisms remain unclear. In this study, we analyzed the hemodynamic changes caused by different stent-placement strategies in patient-specific models using the computational fluid dynamics technique, aiming to provide evidence for clinical decision-making. MATERIALS AND METHODS: Ten vertebral artery fusiform aneurysms were included, and their patient-specific computational fluid dynamics models were reconstructed. A fast virtual stent placement technique was used to simulate sequential multiple stent placements (from a single stent to triple stents) in the vertebral artery fusiform aneurysm models. Hemodynamic parameters, including wall shear stress, pressure, oscillatory shear index, relative residence time, and flow pattern, were calculated and compared among groups with different numbers of stents. RESULTS: Virtual stents were deployed in all 10 cases successfully, consistent with the real stent configuration. Wall shear stress decreased progressively by 7.2%, 20.6%, and 25.8% as the number of stents increased. Meanwhile, relative residence time and pressure increased on average by 11.3%, 15.4%, and 45.0% and by 15.7%, 21.5%, and 28.2%. The oscillatory shear index showed no stable variation trend. Flow patterns improved by weakening the intensity of the vortices and displacing the vortex center from the aneurysmal wall. CONCLUSIONS: Stent placement modifies hemodynamic patterns in vertebral artery fusiform aneurysms, which might favor thrombosis formation in the aneurysmal sac. This effect is amplified with the number of stents deployed. However, a potential risk of rupture or recanalization exists and should be considered when planning to use the multiple stent placement technique in vertebral artery fusiform aneurysms. Fil: Lv, N.. Second Military Medical University. Changhai Hospital; China Fil: Cao, W.. Second Military Medical University. Changhai Hospital; China Fil: Larrabide, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Karmonik, C.. Houston Methodist Research Institute; Estados Unidos Fil: Zhu, D.. Second Military Medical University. Changhai Hospital; China Fil: Liu, J.. Second Military Medical University. Changhai Hospital; China Fil: Huang, Q.. Second Military Medical University. Changhai Hospital; China Fil: Fang, Y.. Second Military Medical University. Changhai Hospital; China |
| Databáze: | OpenAIRE |
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