Prediction of Thrombosis After Coil Embolization of Unruptured Cerebral Aneurysm by Computational Fluid Dynamics Using Porous Media Modeling

IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Masanori Tsuji, Fujimaro Ishida, Yoichi Miura, Takenori Sato, Kazuhiro Furukawa, Ryuta Yasuda, Yasuyuki Umeda, Naoki Toma, Hidenori Suzuki
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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.

Abstract Image

利用多孔介质建模的计算流体力学预测未破裂脑动脉瘤线圈栓塞后的血栓形成
目的根据治疗设备进行术前模拟以预测治疗效果是可取的。我们利用多孔介质建模,通过计算流体动力学(CFD)研究了血管内治疗后颅内动脉瘤完全闭塞(CO)的相关血流动力学。方法从 2015 年 6 月到 2020 年 12 月,我们纳入了在本院接受简单卷绕或支架辅助卷绕治疗的 48 例患者,共 55 例未破裂动脉瘤。患者特定的几何模型由治疗前的三维(D)旋转血管造影或三维计算机断层扫描血管造影生成。我们利用多孔介质模型模拟了线圈和颈桥支架的稳态分析,并计算了线圈栓塞后与血栓形成相关的残余血流量(RFV)。根据治疗 6 个月后的数字减影血管造影结果,将患者分为 CO 组和非 CO 组,并使用 Brunner-Munzel 检验对各组进行统计评估。结果动脉瘤被分为 22 个 CO 组和 33 个非 CO 组。两组动脉瘤的形态学变量无明显差异。在血液动力学参数方面,CO 组的 RFV 明显较低。ROC 曲线分析表明,动脉瘤内平均流速超过 0.5 [cm/s] 的 RFV 对预测 CO 最有用(AUC,0.66 [95% CI,0.51-0.81];临界值,32.8 mm3;敏感性,60.6%;特异性,78.9%)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.30
自引率
5.00%
发文量
81
审稿时长
3 months
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.
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