Document Detail


Critical influence of framing coil orientation on intra-aneurysmal and neck region hemodynamics in a sidewall aneurysm model.
MedLine Citation:
PMID:  21107200     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Although coiling of intracranial aneurysms is thought to rely on obstruction of blood flow into the aneurysm and induction of intra-aneurysmal thrombosis, little data exist regarding the effect of coil deployment on hemodynamics.
OBJECTIVE: To evaluate the effects of simulated coiling of a model aneurysm on flow and wall shear stress in the dome and neck regions using computational fluid dynamic analysis.
METHODS: A spherical sidewall aneurysm on a curved parent vessel underwent simulated embolization with 1 or more computer-designed helical coils. The coils' axes had parallel, orthogonal, or transverse orientation with respect to blood flow. Pulsatile laminar flow computational fluid dynamic analysis was performed on high-resolution conformal meshes of the aneurysm-coil complex using realistic non-Newtonian blood viscosity.
RESULTS: Intra-aneurysmal flow and energy flux into the dome were significantly reduced by coil insertion, with little effect on pressure distribution. Coiling increased viscosity in the distal dome with progressive spread toward the neck with greater coil packing. Coiling also decreased wall shear stress and its gradient both in the inflow zone and the downstream parent vessel. These alterations were dependent on coil orientation, with effectiveness rank order of parallel>transverse>orthogonal.
CONCLUSION: We successfully modeled the hemodynamic effects of aneurysm coil embolization and uncovered a framing coil orientation dependence of dome and parent vessel hemodynamics. In addition to suggesting a pathophysiological link among coil configuration, protection from rupture, and aneurysm regrowth, these results pave the way for the analysis of aneurysm-coil complex interactions on a patient lesion-specific basis.
Authors:
Clemens M Schirmer; Adel M Malek
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  67     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1692-702; discussion 1702     Citation Subset:  IM    
Affiliation:
Cerebrovascular and Endovascular Division, Department of Neurosurgery, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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