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Influence of hemodynamics on recanalization of totally occluded intracranial aneurysms: a patient-specific computational fluid dynamic simulation study.
MedLine Citation:
PMID:  22680247     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Object Some totally occluded intracranial aneurysms may recur. The role of hemodynamic mechanisms in this process remains to be elucidated. The authors used computational fluid dynamic analysis and investigated the local hemodynamic characteristics at the aneurysm neck before and after total embolization, attempting to identify hemodynamic risk factors leading to recurrence of totally embolized aneurysms. Methods Between May 2008 and June 2010, the authors recruited 17 consecutive patients with totally occluded intracranial aneurysms (7 recanalized and 10 stable lesions). Using patient-specific 3D digital subtraction angiography data, the hemodynamic features before and after embolization were retrospectively characterized. Results The overall preembolization blood flow patterns were nearly the same in the recanalized and stable groups, with no significant difference in either the maximum wall shear stress (WSS) (p = 0.914) or the spatially averaged WSS (p = 0.322) at peak systole at the aneurysm neck. After occlusion, the overall flow pattern changed, and the WSS distribution at the treated aneurysm neck differed in the 2 groups. In all of the 7 recanalized cases, both the maximum WSS and spatially averaged WSS at peak systole at the treated aneurysm neck were higher than those at the aneurysm neck before embolization. In contrast, both parameters were decreased in 70%-80% of the stable cases. After embolization, both the maximum WSS (p = 0.021) and spatially averaged WSS (p = 0.041) at peak systole at the treated aneurysm neck were higher in the recanalized group than in the stable group. Conclusions Higher WSS at the treated aneurysm neck after total embolization can be an important hemodynamic factor that contributes to aneurysm recurrence after endovascular treatment.
Authors:
Chuanhui Li; Shengzhang Wang; Jialiang Chen; Hongyu Yu; Ying Zhang; Fan Jiang; Shiqing Mu; Haiyun Li; Xinjian Yang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-8
Journal Detail:
Title:  Journal of neurosurgery     Volume:  -     ISSN:  1933-0693     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Beijing Tiantan Hospital, Beijing Neurosurgical Institute, and.
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