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.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.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.doi http://dx.doi.org/10.3174/ajnr.A3288
• dc.identifier.issn 0195-6108
• dc.identifier.uri http://hdl.handle.net/10230/59145
• 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.relation.projectID info:eu-repo/grantAgreement/EC/FP6/027703
• dc.rights © 2013 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• 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.type.version info:eu-repo/semantics/publishedVersion