Computational fluid dynamics (CFD) analysis in a ruptured vertebral artery dissecting aneurysm implanted by Pipeline when recurrent after LVIS-assisted coiling treatment: Case report and review of the literatures.
aneurysm recurrence
compuational fluid dynamics
finite element analysis
vertebral artery dissecting aneurysm
Journal
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
ISSN: 2385-2011
Titre abrégé: Interv Neuroradiol
Pays: United States
ID NLM: 9602695
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
pmc-release:
01
08
2024
medline:
4
8
2023
pubmed:
30
4
2022
entrez:
29
4
2022
Statut:
ppublish
Résumé
Hemodynamics plays an important role in the natural history of the process of rupture and recurrence of intracranial aneurysms. This study aimed to investigate the role of hemodynamics for recurrence in a vertebral artery dissecting aneurysm (VADA). A patient with a ruptured VADA firstly treated by low-profile visualized intraluminal support (LVIS)-assisted coiling, and was implanted with a Pipeline Embolization Device (PED) after aneurysm recurrence. Finite element analysis and computational fluid dynamics simulations were conducted in 6 serial imaging procedures, and the calculated hemodynamics was correlated with aneurysm recurrence. Wall shear stress (WSS) was not effectively suppressed, resulting in aneurysm recurrence with initial entry tear to occur above the protuberance after 7 months of LVIS stent-assisted coiling. With the implantation of PED, WSS, inflow stream and velocity at the aneurysm neck significantly decreased. During the 3-month follow-up after PED deployment, there was significant shrinkage of the sac and the blood flow in the sac was reduced considerably. The 27-month follow-up after PED deployment indicated the aneurysm was stable. The present case study suggests that insufficient suppression of high WSS and high inflow velocity at the neck of the parent artery, especially near the posterior inferior cerebellar artery, might be associated with aneurysm recurrence.
Sections du résumé
BACKGROUNDS
BACKGROUND
Hemodynamics plays an important role in the natural history of the process of rupture and recurrence of intracranial aneurysms. This study aimed to investigate the role of hemodynamics for recurrence in a vertebral artery dissecting aneurysm (VADA).
METHODS
METHODS
A patient with a ruptured VADA firstly treated by low-profile visualized intraluminal support (LVIS)-assisted coiling, and was implanted with a Pipeline Embolization Device (PED) after aneurysm recurrence. Finite element analysis and computational fluid dynamics simulations were conducted in 6 serial imaging procedures, and the calculated hemodynamics was correlated with aneurysm recurrence.
RESULTS
RESULTS
Wall shear stress (WSS) was not effectively suppressed, resulting in aneurysm recurrence with initial entry tear to occur above the protuberance after 7 months of LVIS stent-assisted coiling. With the implantation of PED, WSS, inflow stream and velocity at the aneurysm neck significantly decreased. During the 3-month follow-up after PED deployment, there was significant shrinkage of the sac and the blood flow in the sac was reduced considerably. The 27-month follow-up after PED deployment indicated the aneurysm was stable.
CONCLUSIONS
CONCLUSIONS
The present case study suggests that insufficient suppression of high WSS and high inflow velocity at the neck of the parent artery, especially near the posterior inferior cerebellar artery, might be associated with aneurysm recurrence.
Identifiants
pubmed: 35484808
doi: 10.1177/15910199221097766
pmc: PMC10399494
doi:
Types de publication
Review
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
442-449Références
Neuropathology. 2000 Mar;20(1):85-90
pubmed: 10935444
Stroke. 2007 May;38(5):1538-44
pubmed: 17395870
PLoS One. 2017 Dec 28;12(12):e0190222
pubmed: 29284057
J Biomech. 2015 Sep 18;48(12):3332-40
pubmed: 26169778
Stroke. 2011 Sep;42(9):2425-30
pubmed: 21778439
J Neurointerv Surg. 2017 Aug;9(8):0
pubmed: 27405312
J Neurointerv Surg. 2018 Aug;10(8):791-796
pubmed: 29246907
J Neuroimaging. 2019 Jul;29(4):447-453
pubmed: 30891876
Acta Neurochir (Wien). 2014 Nov;156(11):2035-40
pubmed: 25257134
J Neurointerv Surg. 2018 Nov;10(11):1102-1107
pubmed: 29549120
Neurosurgery. 2012 Dec;71(6):E1192-200; discussion E1200-1
pubmed: 22948198
J Biomech. 2013 Nov 15;46(16):2809-16
pubmed: 24119679
Radiology. 2003 Jun;227(3):720-4
pubmed: 12773678
Neurosurg Rev. 2007 Jan;30(1):32-8; discussion 38-9
pubmed: 17061136
World Neurosurg. 2018 Nov;119:e395-e402
pubmed: 30071328
Int J Numer Method Biomed Eng. 2019 Nov;35(11):e3256
pubmed: 31483953
Ann Biomed Eng. 2008 Nov;36(11):1793-804
pubmed: 18787954
AJNR Am J Neuroradiol. 2014 Oct;35(10):1849-57
pubmed: 24029393
Front Neurol. 2019 Apr 25;10:429
pubmed: 31105640
Stroke. 2011 Mar;42(3):745-53
pubmed: 21233477
AJNR Am J Neuroradiol. 2014 Jul;35(7):1254-62
pubmed: 23598838
J Neurointerv Surg. 2014 Oct;6(8):595-9
pubmed: 24107598
J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105290
pubmed: 32992205
Stroke. 2011 Jan;42(1):144-52
pubmed: 21106956
World Neurosurg. 2017 Jan;97:344-350
pubmed: 27742509
PLoS One. 2013 Jun 26;8(6):e67169
pubmed: 23840616
J Neurosurg. 2013 Jul;119(1):221-7
pubmed: 23581586
J Transl Med. 2018 Jul 21;16(1):208
pubmed: 30031395
J Biomech. 2007;40(2):412-26
pubmed: 16527284
Neuroradiology. 2008 Apr;50(4):341-7
pubmed: 18043912
World Neurosurg. 2016 May;89:726.e5-726.e10
pubmed: 26780282
Neurosurgery. 2019 Mar 1;84(3):607-615
pubmed: 29566209
J Neurointerv Surg. 2018 Mar;10(3):252-257
pubmed: 28377443
Lancet Neurol. 2015 Jun;14(6):640-54
pubmed: 25987283
IEEE Trans Med Imaging. 2008 Jun;27(6):814-24
pubmed: 18541488
Neurosurg Rev. 2008 Apr;31(2):131-40; discussion 140
pubmed: 18309525
Stroke. 2016 Oct;47(10):2541-7
pubmed: 27625377
Neurointervention. 2016 Mar;11(1):30-6
pubmed: 26958410