Application of virtual deployment and hemodynamic simulation in treatment of a basal arterial dissecting aneurysm using flow diverter: A case report and literature review.

Abstract

The application of flow diverters (FDs) to treat basilar artery (BA) aneurysms has been proven to be one of the most effective ways. The hemodynamic changes caused by FD have been proven to be a principal factor affecting the healing of aneurysms. Virtual deployment based on simulation technology can intuitively reflect the hemodynamic changes caused by FD, providing more information for the surgeon. A 6-year-old child presented with a week of persistent, severe headaches due to a large dissecting aneurysm in the upper-middle BA. To select the appropriate size of the stent and observe the changes in blood flow, the virtual deployment of the FD was completed in AneuPlan. The simulated results were in good agreement with postoperative digital subtraction angiography (DSA). Moreover, hemodynamic analysis indicated the overall thrombosis and healing of the aneurysm and the incomplete occlusion risk close to the left superior cerebellar artery, which was confirmed by the subsequent assessment following the FD deployment. Encouragingly, the DSA images at 28 weeks showed that the residual sac of the basilar artery aneurysm had been basically healed. This case report initially reflects the guiding role of AneuPlan in the endovascular treatment protocol for complex cerebrovascular diseases.