Association between hemodynamic conditions and occlusion times after flow diversion in cerebral aneurysms.

Abstract:

BACKGROUND:Evaluation of flow diversion treatment of intracranial aneurysms is difficult owing to lack of knowledge of the target hemodynamic environment. OBJECTIVE:To identify hemodynamic conditions created after flow diversion that induce fast aneurysm occlusion. METHODS:Two groups of aneurysms treated with flow diverters alone were selected: (a) aneurysms completely occluded at 3 months (fast occlusion), and (b) aneurysms patent or incompletely occluded at 6 months (slow occlusion). A total of 23 aneurysms were included in the study. Patient-specific computational fluid dynamics models were constructed and used to characterize the hemodynamic environment immediately before and after treatment. Average post-treatment hemodynamic conditions between the fast and slow occlusion groups were statistically compared. RESULTS:Aneurysms in the fast occlusion group had significantly lower post-treatment mean velocity (fast=1.13 cm/s, slow=3.11 cm/s, p=0.02), inflow rate (fast=0.47 mL/s, slow=1.89 mL/s, p=0.004) and shear rate (fast=20.52 1/s, slow=32.37 1/s, p=0.02) than aneurysms in the slow occlusion group. Receiver operating characteristics analysis showed that mean post-treatment velocity, inflow rate, and shear rate below a certain threshold could discriminate between aneurysms of the fast and slow occlusion groups with good accuracy (84%, 77%, and 76%, respectively). CONCLUSIONS:The occlusion time of cerebral aneurysms treated with flow diverters can be predicted by the hemodynamic conditions created immediately after device implantation. Specifically, low post-implantation flow velocity, inflow rate, and shear rate are associated with fast occlusion times.

journal_name

J Neurointerv Surg

authors

Mut F,Raschi M,Scrivano E,Bleise C,Chudyk J,Ceratto R,Lylyk P,Cebral JR

doi

10.1136/neurintsurg-2013-011080

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

286-90

issue

4

eissn

1759-8478

issn

1759-8486

pii

neurintsurg-2013-011080

journal_volume

7

pub_type

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