Angiographic quantification of contrast medium washout from cerebral aneurysms after stent placement.
Angiographic quantification of contrast medium washout from cerebral aneurysms after stent placement.
复制标题
支架置入后脑动脉瘤造影剂冲洗的血管造影定量。
DOI：
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
L. Hopkins
中科院分区：
文献类型：
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作者：
C. Sadasivan;B. Lieber;M. Gounis;D. Lopes;L. Hopkins
背景和目的
血管内支架置入术是治疗脑动脉瘤的新兴技术。到目前为止，没有定量方法可用于确定支架展开在减少颅内血流循环方面的有效性，从而将动脉瘤从脑血管系统中排除。我们的目的是建立一个数学模型，该模型与脑动脉瘤中观察到的血流传输现象一致，并基于这些动脉瘤中血管造影造影剂的洗脱，为预测支架置入后稳定血栓形成的可能性提供定量指标。
方法
收集并分析了涉及弹性体侧壁动脉瘤模型的体外实验的血管造影数据和5例脑动脉瘤患者的数据。在每种情况下，选择一个描绘动脉瘤的感兴趣区域（ROI），并评估该ROI内平均灰度强度的时间变化。采用最小二乘最小化方法对灰度强度曲线进行了数学模型拟合。研究了支架置入前后模型参数的变化。
结果
一个显着的变化，在模型参数中观察到在体外的情况下，当数据适用于数学建模从临床设置。这种变化支持了模型的假设。
结论
根据我们的研究结果，我们得出结论，本文开发的模型可用于定量描述和表征血管内支架置入前后动脉瘤血流运输的变化。通过推断，该模型的未来版本将有助于预测手术后立即进行脑动脉瘤血管内支架置入术的长期有效性。
BACKGROUND AND PURPOSE
Endovascular stent placement is an emerging technique in treating cerebral aneurysms. Thus far, no quantitative method is available to determine the effectiveness of stent deployment in reducing intraaneurysmal flow circulation, and thereby, in excluding the aneurysm from the cerebral vasculature. Our purpose was to develop a mathematical model congruent with flow transport phenomena observed in cerebral aneurysms and based on the washout of angiographic contrast medium from these aneurysms to provide quantitative indices for predicting the likelihood of stable thrombus formation after stent placement.
METHODS
Angiographic data from an in vitro experiment involving an elastomer side-wall aneurysm model and data from five patients with cerebral aneurysms were collected and analyzed. A region of interest (ROI) delineating the aneurysm was selected in each case, and the temporal variation in average gray-scale intensity within this ROI was assessed. The mathematical model was fit to the gray-scale intensity curves by using least-squares minimization. Variations in model parameters before and after stent placement were studied.
RESULTS
A marked variation in the model parameters was observed in both in vitro cases and when data suitable for mathematical modeling were available from the clinical setting. This variation supported the hypothesis of the model.
CONCLUSION
On the basis of our results, we conclude that the model developed herein can be used to quantitatively depict and characterize alterations in aneurysmal blood-flow transport before and after endovascular stent placement. By inference, future versions of the model will be useful in predicting the long-term effectiveness of endovascular stent placement for cerebral aneurysms immediately after the procedure is performed.