Flow diverter effect of LVIS stent on cerebral aneurysm hemodynamics: a comparison with Enterprise stents and the Pipeline device.
Flow diverter effect of LVIS stent on cerebral aneurysm hemodynamics: a comparison with Enterprise stents and the Pipeline device.
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DOI：
10.1186/s12967-016-0959-9
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发表时间：
2016-07-02
影响因子：
7.4
通讯作者：
Yang X
中科院分区：
文献类型：
--
作者：
Wang C;Tian Z;Liu J;Jing L;Paliwal N;Wang S;Zhang Y;Xiang J;Siddiqui AH;Meng H;Yang X
本研究的目的是使用计算流体动力学（CFD）量化新型低切迹可视化腔内支撑（LVIS®D）器械的效果以及与Pipeline器械和Enterprise支架相比的液体转向效果差异。在这项研究中，我们模拟了三个动脉瘤构建的三维数字减影血管造影（DSA）。Enterprise、LVIS和Pipeline器械几乎符合血管腔的要求，并穿过动脉瘤开口放置。计算流体动力学分析，比较这些支架之间的血流动力学差异，如WSS，速度和压力。对照组是指无支架模型，血流动力学变化的百分比均与对照组进行比较。单枚LVIS支架引起的壁面剪切应力降低（39.96 vs. 30.51%）和速度降低（23.13 vs. 18.64%）均大于双枚Enterprise支架。双LVIS支架的壁面切应力（63.88%）和流速（46.05%）显著降低。与双LVIS支架相比，单Pipeline支架的WSS（51.08%）和流速（37.87%）降低较少。双Pipeline支架导致WSS（72.37%）和流速（54.26%）降低最多。与未置入支架的模型相比，支架置入后压力增加幅度很小。这是第一项分析与LVIS支架相关的血流改变的研究。我们发现LVIS支架对脑动脉瘤有一定的血流动力学影响：单枚LVIS支架引起的血流减少比双枚Enterprise支架更多，但小于Pipeline器械。然而，双LVIS支架的血流导向效果优于Pipeline器械。
The aim of this study was to quantify the effect of the new Low-profile Visualized Intraluminal Support (LVIS®D) device and the difference of fluid diverting effect compared with the Pipeline device and the Enterprise stent using computational fluid dynamics (CFD). In this research, we simulated three aneurysms constructed from 3D digital subtraction angiography (DSA). The Enterprise, LVIS and the Pipeline device were virtually conformed to fit into the vessel lumen and placed across the aneurysm orifice. Computational fluid dynamics analysis was performed to compare the hemodynamic differences such as WSS, Velocity and Pressure among these stents. Control referred to the unstented model, the percentage of hemodynamic changes were all compared to Control. A single LVIS stent caused more wall shear stress reduction than double Enterprise stents (39.96 vs. 30.51 %) and velocity (23.13 vs. 18.64 %). Significant reduction in wall shear stress (63.88 %) and velocity (46.05 %) was observed in the double-LVIS stents. A single Pipeline showed less reduction in WSS (51.08 %) and velocity (37.87 %) compared with double-LVIS stent. The double-Pipeline stents resulted in the most reduction in WSS (72.37 %) and velocity (54.26 %). Moreover, the pressure increased with minuscule extent after stenting, compared with the unstented model. This is the first study analyzing flow modifications associated with LVIS stents. We found that the LVIS stent has certain hemodynamic effects on cerebral aneurysms: a single LVIS stent caused more flow reductions than the double-Enterprise stent but less than a Pipeline device. Nevertheless, the double-LVIS stent resulted in a better flow diverting effect than a Pipeline device.