Computational fluid dynamic analysis following recurrence of cerebral aneurysm after coil embolization.
Computational fluid dynamic analysis following recurrence of cerebral aneurysm after coil embolization.
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DOI：
10.4103/1793-5482.103706
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发表时间：
2012-07
期刊：
影响因子：
--
通讯作者：
Negoro M
中科院分区：
文献类型：
--
作者：
Irie K;Anzai H;Kojima M;Honjo N;Ohta M;Hirose Y;Negoro M
血流动力学因素被认为在脑动脉瘤的发生、生长和破裂中起重要作用。然而，未完全闭塞的动脉瘤残颈的血流动力学特征及其对血管再通的影响却鲜有报道。本研究通过计算流体动力学分析，对长期随访期间证实再通的未完全闭塞动脉瘤的血流动力学进行了研究。1例破裂的左侧基底动脉-SCA动脉瘤在11年的随访期内未完全闭塞，并显示再通。我们回顾了三维磁共振血管成像的特征。在近全闭塞后的长期随访期内，血流形态、壁面切应力(WSS)和残颈处的血流速度都发生了变化。特别是颈部高WSS区和高血流速度。有趣的是，残颈的这些区域与动脉瘤再通的位置一致。未完全闭塞的动脉瘤残颈附近可见较高的WSS和血流速度，易于再通。提示血流动力学因素在动脉瘤血管内治疗后复发中可能起重要作用。
Hemodynamic factors are thought to play important role in the initiation, growth, and rupture of cerebral aneurysms. However, hemodynamic features in the residual neck of incompletely occluded aneurysms and their influences on recanalization are rarely reported. This study characterized the hemodynamics of incompletely occluded aneurysms that had been confirmed to undergo recanalization during long-term follow-up using computational fluid dynamic analysis. A ruptured left basilar-SCA aneurysm was incompletely occluded and showed recanalization during 11 years follow-up period. We retrospectively characterized on three-dimensional MR angiography. After subtotal occlusion, the flow pattern, wall shear stress (WSS), and velocity at the remnant neck changed during long-term follow-up period. Specifically, high WSS region and high blood flow velocity were found near the neck. Interestingly, these area of the remnant neck coincided with the location of aneurysm recanalization. High WSS and blood flow velocity were consistently observed near the remnant neck of incompletely occluded aneurysm, prone to future recanalization. It will suggest that hemodynamic factors may play important roles in aneurismal recurrence after endovascular treatment.