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Intra-aneurysmal pressure and flow changes induced by flow diverters: relation to aneurysm size and shape

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dc.contributor.author Larrabide, Ignacio, 1978-
dc.contributor.author Aguilar, María Laura
dc.contributor.author Morales, Hernán G.
dc.contributor.author Geers, Adrianus Johannes
dc.contributor.author Kulcsár, Zsolt
dc.contributor.author Rüfenacht, Daniel
dc.contributor.author Frangi Caregnato, Alejandro
dc.date.accessioned 2024-02-19T10:09:16Z
dc.date.available 2024-02-19T10:09:16Z
dc.date.issued 2013
dc.identifier.citation Larrabide I, Aguilar ML, Morales H, Geers A, Kulcsár Z, Rüfenacht D, et al. Intra-aneurysmal pressure and flow changes induced by flow diverters: relation to aneurysm size and shape. American Journal of Neuroradiology. 2013 Apr 1;34(4):816-22. DOI: 10.3174/ajnr.A3288
dc.identifier.issn 0195-6108
dc.identifier.uri http://hdl.handle.net/10230/59145
dc.description.abstract Background and purpose: Effects of blood flow modification by flow diverters are observed to lead often to aneurysm thrombosis and reverse remodeling. For this process, to further understand the potential roles of intra-aneurysmal blood pressure changes and aneurysm morphologies, 23 patients were studied by numeric simulation. Materials and methods: 3D imaging of aneurysms of different sizes and shapes, all located at the supraclinoid segment of the ICA (n = 23), was prepared for CFD simulations. Hemodynamic variables were calculated for conditions before and after virtual FD implantation, reconstituting a vessel wall scaffold across the aneurysm neck. WSS, velocity, residence time, turnover time, and intra-aneurysmal pressure were assessed statistically. Results: After placement of FDs, significant reductions inside the aneurysm were observed for most hemodynamic variables (P < .01) except mean intra-aneurysmal pressures. For minimum/maximum intra-aneurysmal pressure values, small but significant changes were found; however, they were considered too small to be of relevance. Conclusions: Calculations in 23 cases did not reveal significant intra-aneurysmal mean or peak pressure changes, indicating a minor role of pressure changes in the rare event of secondary ruptures after FD use. Other hemodynamic variables (WSS and velocity) exhibited more significant changes, indicating their role in intra-aneurysmal thrombus formation. Size-dependent, significantly higher reduction in WSS (P = .069) and velocity (P = .013) was observed in small aneurysms compared with larger ones. When it came to shape, there were significantly higher reductions in WSS (P = .055) and velocity (P = .065) and a significantly higher increase in turnover time in fusiform aneurysms compared with saccular aneurysms.
dc.description.sponsorship This research has been partially funded by the Industrial and Technological Development Center (CDTI) under the CENIT-CDTEAM and CENIT-cvREMOD programs, the European Commission project @neurIST (IST-2005-027703), and Philips Healthcare.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher American Society of Neuroradiology
dc.relation.ispartof American Journal of Neuroradiology. 2013 Apr 1;34(4):816-22
dc.rights © 2013 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org.
dc.subject.other Aneurismes cerebrals
dc.subject.other Imatgeria tridimensional en medicina
dc.subject.other Hemodinàmica
dc.title Intra-aneurysmal pressure and flow changes induced by flow diverters: relation to aneurysm size and shape
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3174/ajnr.A3288
dc.relation.projectID info:eu-repo/grantAgreement/EC/FP6/027703
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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