计算机模拟支架植入后载瘤动脉位移对动脉瘤复发的流体力学影响

支架辅助栓塞成为多数分叉部宽颈动脉瘤的首选治疗方法。颅内远端分叉部动脉瘤游离于蛛网膜下腔，支架释放后载瘤动脉变形明显，局部流体力学可能发生明显改变，进而影响动脉瘤的生物学特性。计算机模拟流体力学已被应用于颅内动脉瘤治疗的研究，但对游离于蛛网膜下腔的分叉部动脉瘤支架后载瘤动脉成角重塑后流体力学变化的研究尚未见报道。.本研究首次利用三维血管刚性壁模型、各种颅内支架模型及弹簧圈多孔介质模型，采用优化版有限元法模拟支架释放技术，结合支架网孔对流体力学参数的影响因素，研究支架释放前后及栓塞后的载瘤动脉瘤颈处成角重塑引起的局部流体力学参数变化；对比研究相应病例单纯栓塞的局部流体力学参数，通过长期随访单纯栓塞与支架辅助病例的复发概率有无差异，寻找支架影响动脉瘤生长和栓塞后复发的流体力学特征性参数，为支架辅助栓塞远端分叉部动脉瘤方案设计提供理论依据。

Stent–assisted embolization has become the first line therapy for almost bifurcation aneurysms. Due to intracranial distal bifurcation aneurysms are located in the subarachnoid space, parent arteries shape change significantly after Stent–assisted deployment leading to local hemodynamics obviously change and affect the biological features of the aneurysms. Computational flow dynamics (CFD) has been used in studying the intracranial aneurysms, but as for these aspects study has no reports about hemodynamics changes of parent arteries after stent deployment for these bifurcation aneurysms in the subarachnoid space..This study first use the 3D rigid vascular wall models, various intracranial stent models and coil porosity medium model, adopt modified finite element method simulation release of the stents technique. Combining the effect factors of the hydromechanics parameters determined by the stent struts, we study the local hydromechanics parameters changes determined by the angle alteration on the neck of parent artery at stent pre-implanted, post and follow up. Comparative study corresponding cases adopt the coiling technique is to find the discrepancy the recurrence arte via the long–term follow up in order to seek the hydromechanics characteristic parameters influencing the growth and recurrence of aneurysms for treatment of the distal bifurcation affording the theoretical foundation.