Quantitative Effects of Coil Packing Density on Cerebral Aneurysm Fluid Dynamics: An <Emphasis Type="Italic">In Vitro</Emphasis> Steady Flow Study |
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Authors: | M Haithem Babiker L Fernando Gonzalez Felipe Albuquerque Daniel Collins Arius Elvikis David H Frakes |
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Institution: | (1) School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler, ECG 334, P.O. Box 879709, Tempe, AZ 85287-9709, USA;(2) Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA;(3) Partnership for Research in Spatial Modeling, Arizona State University, Tempe, AZ, USA;(4) School of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, AZ, USA |
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Abstract: | Over the past 15 years, coil embolization has emerged as an effective treatment option for cerebral aneurysms that is far
less invasive than the long-standing convention of surgical clipping. However, aneurysm recurrence after coil embolization
is not uncommon: recurrence rates as high as 50% have been reported in the literature. One factor that may contribute to recurrence
after coiling is residual flow into the aneurysmal sac. At present, there is limited quantitative knowledge of the relationship
between coil packing density and aneurysmal inflow. We present an in vitro fluid dynamic study of basilar tip aneurysm models that elucidates this relationship. At physiologically normal flow rates,
we found that a packing density of 28.4% decreased aneurysmal inflow by 31.6% in a wide-neck model, and that a packing density
of 36.5% decreased aneurysmal inflow by 49.6% in a narrow-neck model. Results also indicated that coiling reduced aneurysmal
inflow more significantly at lower parent vessel flow rates, and that coiling reduced neck-plane velocity magnitudes more
significantly for narrow-neck aneurysms. Our study provides novel quantitative information that could ultimately contribute
to improved outcomes for patients with cerebral aneurysms by enabling more effective coil embolization. |
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