颅内动脉瘤单纯弹簧圈栓塞术后瘤颈残留复发的血流动力学研究

近十几年来，随着血管内介入新技术的不断发展，血管内栓塞成为许多颅内动脉瘤首选的治疗方案。颅内动脉瘤单纯弹簧圈栓塞后瘤颈残留的复发通常受多因素影响，其机制尚不清楚，是临床上的重要难题，并严重制约了这一先进技术的临床推广运用。近年来，随着流体力学和计算机模拟技术的发展及其与临床工作日益紧密的联系，越来越多的研究提示颅内动脉瘤的血流动力学参数变化可能与其复发相关。 本研究首次采用三维血管弹性壁模型及弹簧圈多孔介质模型模拟单纯弹簧圈栓塞后的动脉瘤血流动力学状态，利用流体力学原理，通过计算机软件重建栓塞后瘤颈残余复发动脉瘤和未复发动脉瘤的血液动力学模型，比较相关流体力学参数的差异，结合动脉瘤形态学参数及患者的临床参数，使用智能化的统计分类工具，研究颅内动脉瘤栓塞术后瘤颈残留复发的血流动力学机制，为临床上颅内动脉瘤的治疗策略选择提供参考。

With the improvement of embolic techniques, endovascular embolization has been widely used as a safe and effective treatment method in intracranial aneurysms. However, the recurrence of the aneurysms after coil embolization still remains a major problem. It is usually influenced by multiple factors and the pathogenesis is still unclear. With the rapid development of diagnostic technique using hydromechanics and numeral simulation of computational fluid dynamics, several studies suggested that internal flow hemodynamics possibly have some effect on the recurrence of coiled aneurysms. We employ elastic wall model and porous medium model to simulate the coiled aneurysms. Using fluid mechanics and computational fluid dynamic analysis software to design the hemodynamic models of the recurrence and stable aneurysms. We analyse the hemodynamic, geometric and clinical features of these aneurysms, using intelligent statistical classification tools to investigate the recurrence mechanisms of coiled aneurysms，and to provide some references for treatment of intracranial aneurysms.