Three-dimensional pulsatile flow simulation before and after endovascular coil embolization of a terminal cerebral aneurysm
Three-dimensional pulsatile flow simulation before and after endovascular coil embolization of a terminal cerebral aneurysm
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DOI：
10.1097/00004647-200112000-00011
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发表时间：
2001-12-01
影响因子：
6.3
通讯作者：
Zeumer, H
中科院分区：
文献类型：
--
作者：
Groden, C;Laudan, J;Zeumer, H
本文探讨了不同比例的弹簧圈对载瘤血管和动脉瘤腔内脉动流量和压力的影响。通过计算机断层血管成像获得蛛网膜下腔出血后基底动脉和椎基底动脉的几何数据。在使用可拆卸弹簧圈治疗前后，测量四个椎基底动脉点的动脉内压。使用商用流体动力学求解器对四种情况下的动脉瘤进行三维计算机模拟：(1)介入前；(2)20%填充显示完全停止了通过动脉瘤颈的流入；(3)12%填充显示通过动脉瘤颈部的流入不完全减速，(4)12%填充显示通过动脉瘤颈的流入不完全减速，(4)12%填充和模拟凝结的动脉瘤穹顶，并没有抑制持续的流动现象。在不同的模拟动脉瘤充填条件下，相对压力幅值既没有增加，也没有减少。插入的铂金线圈可以立即、果断地缓解脉动的血液流入，并允许最初的凝血。为了达到这一效果，需要在动脉瘤颈中加入20%的铂金弹簧网。
The effect of different percentages of coil mesh in a cerebral aneurysm on the pulsatile flow and pressure in the parent vessel and aneurysm lumen was evaluated. Geometric data on a basilar tip aneurysm and vertebrobasilar arteries after subarachnoid hemorrhage was obtained by computer tomographic angiography. Intraarterial pressure was measured at four vertebrobasilar points before and after treatment with detachable coils. Pulsatile flow was documented by transcranial ultrasonography, A three-dimensional computer simulation was created using a commercial fluid dynamics solver for four aneurysm conditions: (1) before intervention; (2) with a 20% filling showing a complete cessation of the inflow through the aneurysm neck; (3) with a 12% filling showing an incomplete deceleration of inflow through the aneurysm neck, with a remaining flow around the embedded platinum coils and (4) with a 12% filling and simulation of clotted aneurysm dome, which did not inhibit persisting flow phenomena. The relative pressure amplitudes neither increased nor decreased under the different simulated aneurysm filling conditions. Inserted platinum coils can immediately and decisively relieve the influx of pulsating blood and allow for initial clotting. To reach this effect, a volume density of 20% platinum coil mesh in the aneurysm neck is needed.