{"title":"Prediction of Thrombosis After Coil Embolization of Unruptured Cerebral Aneurysm by Computational Fluid Dynamics Using Porous Media Modeling","authors":"Masanori Tsuji, Fujimaro Ishida, Yoichi Miura, Takenori Sato, Kazuhiro Furukawa, Ryuta Yasuda, Yasuyuki Umeda, Naoki Toma, Hidenori Suzuki","doi":"10.1007/s40846-023-00839-3","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Preoperative simulations tailored to the therapeutic device are desirable to predict treatment efficacy. We investigated the hemodynamics associated with complete obliteration (CO) of intracranial aneurysms after endovascular treatment by computational fluid dynamics (CFD) using porous media modeling.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>From June 2015 to December 2020, 48 patients with 55 unruptured aneurysms treated with simple coiling or stent-assisted coiling at our institution were included. Patient-specific geometry models were generated from pre-treatment 3 dimension (D) rotational angiography or 3D computed tomography angiography. We simulated the coil and neck-bridging stent with porous media modeling for steady state analysis and calculated residual flow volume (RFV) associated with thrombosis formation after coil embolization. Patients were classified into CO and non-CO groups based on digital subtraction angiography findings after 6 months of treatment, and the groups were statistically evaluated using the Brunner-Munzel test. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic accuracy in predicting CO.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The aneurysms were classified into 22 CO and 33 non-CO group. There were no significant differences in morphological variables between the two groups. In hemodynamic parameters, RFV was significantly lower in the CO group. The ROC curve analyses showed that RFV with an average flow velocity of more than 0.5 [cm/s] in aneurysm was the most useful to predict CO (AUC, 0.66 [95% CI, 0.51–0.81]; cut-off value, 32.8 mm<sup>3</sup>; sensitivity, 60.6%; and specificity, 78.9%).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>These results indicated that CFD could predict aneurysmal CO after coil embolization.</p>","PeriodicalId":50133,"journal":{"name":"Journal of Medical and Biological Engineering","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical and Biological Engineering","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s40846-023-00839-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose
Preoperative simulations tailored to the therapeutic device are desirable to predict treatment efficacy. We investigated the hemodynamics associated with complete obliteration (CO) of intracranial aneurysms after endovascular treatment by computational fluid dynamics (CFD) using porous media modeling.
Methods
From June 2015 to December 2020, 48 patients with 55 unruptured aneurysms treated with simple coiling or stent-assisted coiling at our institution were included. Patient-specific geometry models were generated from pre-treatment 3 dimension (D) rotational angiography or 3D computed tomography angiography. We simulated the coil and neck-bridging stent with porous media modeling for steady state analysis and calculated residual flow volume (RFV) associated with thrombosis formation after coil embolization. Patients were classified into CO and non-CO groups based on digital subtraction angiography findings after 6 months of treatment, and the groups were statistically evaluated using the Brunner-Munzel test. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic accuracy in predicting CO.
Results
The aneurysms were classified into 22 CO and 33 non-CO group. There were no significant differences in morphological variables between the two groups. In hemodynamic parameters, RFV was significantly lower in the CO group. The ROC curve analyses showed that RFV with an average flow velocity of more than 0.5 [cm/s] in aneurysm was the most useful to predict CO (AUC, 0.66 [95% CI, 0.51–0.81]; cut-off value, 32.8 mm3; sensitivity, 60.6%; and specificity, 78.9%).
Conclusion
These results indicated that CFD could predict aneurysmal CO after coil embolization.
期刊介绍:
The purpose of Journal of Medical and Biological Engineering, JMBE, is committed to encouraging and providing the standard of biomedical engineering. The journal is devoted to publishing papers related to clinical engineering, biomedical signals, medical imaging, bio-informatics, tissue engineering, and so on. Other than the above articles, any contributions regarding hot issues and technological developments that help reach the purpose are also included.