Computational fluid dynamics analysis on recurrence of simple coiling intracranial aneurysms with remnant neck
Computational fluid dynamics analysis on recurrence of simple coiling intracranial aneurysms with remnant neck
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DOI：
10.1186/s41016-016-0050-7
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发表时间：
2016-10
影响因子：
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通讯作者：
Xilong Yu;G. Lu;Shengzhang Wang;Lei Huang;L. Ge;Jun Wan;R. Di;Yeqing Jiang;Xiaolong Zhang
中科院分区：
文献类型：
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作者：
Xilong Yu;G. Lu;Shengzhang Wang;Lei Huang;L. Ge;Jun Wan;R. Di;Yeqing Jiang;Xiaolong Zhang
背景血流动力学因素被认为在脑动脉瘤的发生和复发中发挥重要作用。然而，导致动脉瘤复发的血流动力学特征尚未得到充分认识。本研究对单纯弹簧圈和残余颈动脉瘤的血流动力学进行分析，探讨血流动力学因素对脑动脉瘤复发的影响。方法本研究选取3例至少进行过一次血管造影随访的单纯弹簧圈和残余颈动脉瘤。通过 3D 旋转 DSA 和血管 3D 重建进行随访。动脉瘤位于ICA眼段，其中复发病例1例，稳定病例2例。采用多孔介质模型对动脉瘤的血流动力学进行模拟和分析。结果对于再通的动脉瘤，术后即刻，残颈处的WSS降低，瘤囊内血流速度较低，存在停滞区。第一次随访时，与术后即刻相比，残颈处的WSS更高，血流冲击更强。在囊内，停滞面积减少，其轮廓界限收缩至动脉瘤内。然而，在第二次随访中，与前次随访相比，残颈处的WSS较低，血流冲击较弱，而囊内的停滞区域扩大。结论动脉瘤复发可能分两个阶段发生：早期因血流冲击导致的弹簧圈压实，以及后期因血流动力学影响而导致的血管重塑。
BackgroundHemodynamic factors are considered to play an important role in the initiation and recurrence of cerebral aneurysms. However, hemodynamic characteristics leading to the recurrence of aneurysms is not well recognized. This study analyzes the hemodynamics of simple-coiling and remnant-neck aneurysms, and discusses the impact of hemodynamic factors on the recurrence of cerebral aneurysms.MethodsThis study selected three simple-coiled and remnant-neck aneurysms with at least once angiographic follow-up. The follow-up was conducted by 3D rotational DSA and the 3D reconstruction of the vessel. The aneurysms located on ophthalmic segment of ICA, including one recurrent case and two stable cases. We used a porous medium model to simulate and analyze the hemodynamics of aneurysms.ResultsFor the recanalized aneurysm, in the immediate post-operative period, the WSS at the remnant neck decreased, low blood flow velocity and stagnant regions were found in the aneurysm sac. In the first follow-up, compared to immediately post-operative, at the residual neck, the WSS was higher, the flow impingement was stronger. In the sac, the stagnation area decreased and its contour limit shrank into the aneurysm. However, in the second follow-up, compared to the previous follow-up, at the remnant neck, the WSS was lower, the flow impingement weaker, while in the sac the stagnant region expanded.ConclusionsAneurysm recurrence could occur in two phases: early coil compaction resulting from blood flow impingement and later vessel remodeling due to hemodynamic effects.