Quantitative Effects of Coil Packing Density on Cerebral Aneurysm Fluid Dynamics: An In Vitro Steady Flow Study
Quantitative Effects of Coil Packing Density on Cerebral Aneurysm Fluid Dynamics: An In Vitro Steady Flow Study
复制标题
DOI：
10.1007/s10439-010-9995-4
复制
发表时间：
2010-07-01
影响因子：
3.8
通讯作者：
Frakes, David H.
中科院分区：
文献类型：
--
作者：
Babiker, M. Haithem;Gonzalez, L. Fernando;Frakes, David H.
在过去的15年中，弹簧圈栓塞已成为脑动脉瘤的有效治疗选择，其侵入性远低于长期使用的手术夹闭。然而，弹簧圈栓塞后动脉瘤复发并不罕见：文献中报告的复发率高达50%。弹簧圈栓塞后可能导致复发的一个因素是残余血流进入膀胱囊。目前，对盘管装填密度与系统流入量之间的关系的定量认识有限。我们提出了一个体外流体动力学研究基底动脉尖动脉瘤模型，阐明了这种关系。在生理正常流速下，我们发现，在宽颈模型中，28.4%的填充密度使动脉流入减少了31.6%，在窄颈模型中，36.5%的填充密度使动脉流入减少了49.6%。结果还表明，在载瘤血管流速较低时，弹簧圈栓塞术更显著地减少了动脉瘤流入，对于窄颈动脉瘤，弹簧圈栓塞术更显著地减少了颈平面速度幅度。我们的研究提供了新的定量信息，通过实现更有效的弹簧圈栓塞，最终有助于改善脑动脉瘤患者的结局。
Over the past 15 years, coil embolization has emerged as an effective treatment option for cerebral aneurysms that is far less invasive than the long-standing convention of surgical clipping. However, aneurysm recurrence after coil embolization is not uncommon: recurrence rates as high as 50% have been reported in the literature. One factor that may contribute to recurrence after coiling is residual flow into the aneurysmal sac. At present, there is limited quantitative knowledge of the relationship between coil packing density and aneurysmal inflow. We present an in vitro fluid dynamic study of basilar tip aneurysm models that elucidates this relationship. At physiologically normal flow rates, we found that a packing density of 28.4% decreased aneurysmal inflow by 31.6% in a wide-neck model, and that a packing density of 36.5% decreased aneurysmal inflow by 49.6% in a narrow-neck model. Results also indicated that coiling reduced aneurysmal inflow more significantly at lower parent vessel flow rates, and that coiling reduced neck-plane velocity magnitudes more significantly for narrow-neck aneurysms. Our study provides novel quantitative information that could ultimately contribute to improved outcomes for patients with cerebral aneurysms by enabling more effective coil embolization.