Stent-assisted coiling technology has been widely used in the treatment of intracranial aneurysms. In the current study, we investigated the intra-aneurysmal hemodynamic alterations after stent implantation and their association with the aneurysm location. We first retrospectively studied 15 aneurysm cases [8 internal carotid artery-ophthalmic artery (ICA-OphA) aneurysms and 7 posterior communicating artery (PcoA) aneurysms] treated with Enterprise stents and coils. Then, based on the patient-specific geometries before and after stenting, we built virtual stenting computational fluid dynamics (CFD) simulation models. Before and after the stent deployment, the average wall shear stress (WSS) on the aneurysmal sac at systolic peak changed from 7.04 Pa (4.14 Pa, 15.77 Pa) to 6.04 Pa (3.86 Pa, 11.13 Pa), P = 0.001; the spatially averaged flow velocity in the perpendicular plane of the aneurysm dropped from 0.5 m/s (0.28 m/s, 0.7 m/s) to 0.33 m/s (0.25 m/s, 0.49 m/s), P = 0.001, respectively. Post stent implantation, the WSS in ICA-OphA aneurysms and PcoA aneurysms decreased by 14.4 % (P = 0.012) and 16.6 % (P = 0.018), respectively, and the flow velocity also reduced by 10.3 % (P = 0.029) and 10.5 % (P = 0.013), respectively. Changes in the WSS, flow velocity, and pressure were not significantly different between ICA-OphA and PcoA aneurysms (P > 0.05). Stent implantation did not significantly change the peak systolic pressure in either aneurysm type. After the stent implantation, both the intra-aneurysmal flow velocity and WSS decreased independently of aneurysm type (ICA-OphA and PcoA). Little change was observed in peak systolic pressure.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81301003, 81171079, 81371315, 81471167, 81220108007]; Special Research Project for Capital Health Development [2014-1-1071]; National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [R01 NS091075]
第一作者机构:[1]Capital Med Univ, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, TiantanXili 6, Beijing 100050, Peoples R China;[2]Capital Med Univ, Beijing Tian Tan Hosp, TiantanXili 6, Beijing 100050, Peoples R China;
通讯作者:
通讯机构:[1]Capital Med Univ, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, TiantanXili 6, Beijing 100050, Peoples R China;[2]Capital Med Univ, Beijing Tian Tan Hosp, TiantanXili 6, Beijing 100050, Peoples R China;
推荐引用方式(GB/T 7714):
Wang Chao,Tian Zhongbin,Liu Jian,et al.Hemodynamic alterations after stent implantation in 15 cases of intracranial aneurysm[J].ACTA NEUROCHIRURGICA.2016,158(4):811-819.doi:10.1007/s00701-015-2696-x.
APA:
Wang, Chao,Tian, Zhongbin,Liu, Jian,Jing, Linkai,Paliwal, Nikhil...&Yang, Xinjian.(2016).Hemodynamic alterations after stent implantation in 15 cases of intracranial aneurysm.ACTA NEUROCHIRURGICA,158,(4)
MLA:
Wang, Chao,et al."Hemodynamic alterations after stent implantation in 15 cases of intracranial aneurysm".ACTA NEUROCHIRURGICA 158..4(2016):811-819