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 Surgjournal_title
Journal of neurointerventional surgeryauthors
Mut F,Raschi M,Scrivano E,Bleise C,Chudyk J,Ceratto R,Lylyk P,Cebral JRdoi
10.1136/neurintsurg-2013-011080subject
Has Abstractpub_date
2015-04-01 00:00:00pages
286-90issue
4eissn
1759-8478issn
1759-8486pii
neurintsurg-2013-011080journal_volume
7pub_type
杂志文章abstract:BACKGROUND:Malignant gliomas continue to have a poor clinical outcome with available therapies. In the past few years, new targeted biologic therapies have been studied, with promising results. However, owing to problems with ineffective IV delivery of these newer agents, an alternative, more direct delivery mechanism ...
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pub_type: 杂志文章
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journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
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更新日期:2019-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
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journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
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journal_title:Journal of neurointerventional surgery
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