颅内动脉瘤Enterprise支架辅助弹簧圈栓塞术后的血流动力学变化:基于计算流体力学分析

目的 探讨颅内动脉瘤Enterprise支架辅助弹簧圈栓塞后瘤腔和载瘤动脉的血流动力学改变.方法 回顾性分析2021年3～8月Enterprise支架辅助弹簧圈栓塞治疗的24例颅内动脉瘤的临床资料.收集术前、术后即刻动脉瘤瘤腔和载瘤动脉处DSA数据的DICOM格式,导入OpenFOAM软件,应用计算流体力学数值模拟技术...

Hemodynamic changes of intracranial aneurysms after Enterprise stent-assisted coil embolization:an analysis using computational fluid dynamics

Objective To investigate the hemodynamic changes of the intracranial aneurysms after Enterprise stent-assisted coil embolization. Methods The clinical data of 24 patients with intracranial aneurysm who received Enterprise stent-assisted coil embolization from March to August 2021 were retrospectively analyzed. The DSA data of the aneurysmal sacs and parent arteries before and immediately after the embolization were put into the OpenFOAM software to analyze the hemodynamics using computational fluid dynamics technique and the hemodynamic parameters including wall shear stress (WSS), normalized WSS (NWSS), WSS gradient (WSSG), streamwise WSSG (SWSSG), normalized pressure (NP) and oscillatory shear index (OSI) were calculated. Results Twenty-four Enterprise stents were used in these 24 patients. Immediate postoperative angiography showed that Raymond grade Ⅰ was achieved in 18 patients and grade Ⅱ in 6. After the embolization, the WSS, the NWSS, the minimum value of NWSS, the WSSG and the minimum value of WSSG were significantly increased (P<0.05), and the maximum value of WSSG was significantly decreased (P<0.05). Conclusions Enterprise stent-assisted coil embolization significantly modifies the hemodynamic patterns of intracranial aneurysms, which help promote the thrombosis formation in the aneurysmal sacs. After embolization, both the parent artery and the blood flow of aneurysmal sac are reconstructed, the vortex of aneurysmal sac is reduced or disappeared and the blood flow patterns change from complex to simple.