Flow changes caused by the sequential placement of stents across the neck of sidewall cerebral aneurysms
Flow changes caused by the sequential placement of stents across the neck of sidewall cerebral aneurysms
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DOI：
10.3171/jns.2005.103.5.0891
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发表时间：
2005-11-01
影响因子：
4.1
通讯作者：
Nelson, PK
中科院分区：
文献类型：
--
作者：
Cantón, G;Levy, DI;Nelson, PK
目的。本研究的目的是量化在侧壁脑动脉瘤颈上顺序放置支架所导致的速度、涡度和剪切应力的减少。方法。数字粒子图像测速 (DPIV) 系统用于测量柔性硅胶侧壁颅内动脉瘤模型内以及该模型中动脉瘤颈-载瘤动脉界面处的脉动速度场。 DPIV 系统能够对动脉瘤袋和载瘤血管内“血”流的速度矢量场及其在心动周期不同阶段的变化提供瞬时、定量的二维测量。然后根据速度场数据计算相应的涡度和剪切应力场。随后将三个 Neuroform 支架（Boston Scientific/Target）的支柱厚度在 60 至 65 μm 之间，随后放置在动脉瘤模型的颈部，并在放置每个支架后进行测量。作者测量了放置 1 个、2 个和 3 个支架后最大平均速度、涡度和剪切应力的值一致下降。对囊内循环的测量表明，由于支架的放置，涡流强度系统性降低。在放置第一个支架后，上述数量的减少是显着的。放置两个或三个支架导致的减少不如放置第一个支架显着。结论。多个柔性血管内支架的使用有效地降低了动脉瘤囊中形成的涡流的强度，并导致作用在动脉瘤壁上的应力大小降低。
Object. The goal of this study was to quantify the reduction in velocity, vorticity, and shear stresses resulting from the sequential placement of stents across the neck of sidewall cerebral aneurysms.Methods. A digital particle image velocimetry (DPIV) system was used to measure the pulsatile velocity field within a flexible silicone sidewall intracranial aneurysm model and at the aneurysm neck-parent artery interface in this model. The DPIV system is capable of providing an instantaneous, quantitative two-dimensional measurement of the velocity vector field of "blood" flow inside the aneurysm pouch and the parent vessel, and its changes at varying stages of the cardiac cycle. The corresponding vorticity and shear stress fields are then computed from the velocity field data. Three Neuroform stents (Boston Scientific/Target), each with a strut thickness between 60 and 65 mu m, were subsequently placed across the neck of the aneurysm model and measurements were obtained after each stent had been placed.The authors measured a consistent decrease in the values of the maximal averaged velocity, vorticity, and shear stress after placing one, two, and three stents. Measurements of the circulation inside the sac demonstrated a systematic reduction in the strength of the vortex due to the stent placement. The decrease in the magnitude of the aforementioned quantities after the first stent was placed was remarkable. Placement of two or three stents led to a less significant reduction than placement of the first stent.Conclusions. The use of multiple flexible intravascular stents effectively reduces the strength of the vortex forming in an aneurysm sac and results in a decrease in the magnitude of stresses acting on the aneurysm wall.