Our capricious vessels: The influence of stent design and vessel geometry on the mechanics of intracranial aneurysm stent deployment
Our capricious vessels: The influence of stent design and vessel geometry on the mechanics of intracranial aneurysm stent deployment
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DOI：
10.1016/j.jbiomech.2012.03.012
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发表时间：
2012-05-11
影响因子：
2.4
通讯作者：
Segers, P.
中科院分区：
文献类型：
--
作者：
De Bock, S.;Iannaccone, F.;Segers, P.
人们对虚拟工具越来越感兴趣，以帮助临床医生评估不同的血管内治疗程序和设备。在本研究中，我们使用有限元分析来研究支架设计和血管几何形状对支架辅助弹簧圈治疗颅内动脉瘤的影响。进行了9种虚拟支架手术：三种镍钛合金支架设计((I)类似Neuroform的开放细胞支架，(Ii)通用刚性支架和(Iii)更灵活的闭合细胞支架设计)，部署在三个患者特定的脑动脉瘤血管中。我们调查了覆盖动脉瘤颈部的支架面积的百分比，支架置入对脑血管系统的伸直(通过曲度的减少来量化)，以及支架与血管壁的对接(以距离血管0.2 mm内的支柱的百分比来量化)。结果表明，与刚性(7.8+/-1.6%)和柔性(8.7+/-1.6%)闭合支架相比，开放细胞设计更好地覆盖动脉瘤颈部(11.0+/-1.1%)。血管伸直程度较小(-5.1+/-1.6%比-42.9+/-9.8%和-26.9+/-11.9%)。然而，与柔性(73.4+/-4.6%)和刚性(70.4+/-5.1%)的封闭式设计相比，开放式单元式设计中与血管壁相对较好的支柱(56.0+/-6.4%)较少。通过目前的研究，我们希望利用一种新的患者特定环境作为一种可能的术前工具来评估不同血管几何形状下的机械支架行为，从而为动脉瘤的治疗做出贡献和改进。(C)2012爱思唯尔有限公司。保留所有权利。支架必须具有纵向柔韧性，以适应弯曲
There is a growing interest in virtual tools to assist clinicians in evaluating different procedures and devices for endovascular treatment. In the present study we use finite element analysis to investigate the influence of stent design and vessel geometry for stent assisted coiling of intracranial aneurysms. Nine virtual stenting procedures were performed: three nitinol stent designs ((i) an open cell stent resembling the Neuroform, (ii) a generic stiff and (iii) a more flexible closed cell design), were deployed in three patient-specific cerebral aneurysmatic vessels. We investigated the percentage of strut area covering the aneurysm neck, the straightening induced on the cerebrovasculature by the stent placement (quantified by the reduction in tortuosity), and stent apposition to the wall (quantified as the percentage of struts within 0.2 mm of the vessel).The results suggest that the open cell design better covers the aneurysm neck (11.0 +/- 1.1%) compared to both the stiff (7.8 +/- 1.6%) and flexible (8.7 +/- 1.6%) closed cell stents, and induces less straightening of the vessel (-5.1 +/- 1.6% vs. -42.9 +/- 9.8% and -26.9 +/- 11.9%). The open cell design has, however, less struts apposing well to the vessel wall (56.0 +/- 6.4%) compared to the flexible (73.4 +/- 4.6%) and stiff (70.4 +/- 5.1%) closed cell design. With the presented study, we hope to contribute to and improve aneurysm treatment, using a novel patient specific environment as a possible pre-operative tool to evaluate mechanical stent behavior in different vascular geometries. (C) 2012 Elsevier Ltd. All rights reserved. stents must have longitudinal flexibility to adapt to the curved