分流装置对胎儿后交通动脉瘤的血流动力学改变:使用 CFD 进行模拟研究,比较超越流线型、管道柔性和管桥装置

IF 3 3区 医学 Q2 CLINICAL NEUROLOGY
Yu Fu , Xin Bian , Rong Zou , Rongbo Jin , Xiaochang Leng , Feng Fan , Sen Wei , Xuan Cui , Jianping Xiang , Sheng Guan
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引用次数: 0

摘要

目的传统的血流分流器(FD)治疗胎儿后交通动脉瘤的效果并不理想。Surpass Streamline 是一种新型的血流分流器,具有不同的网状特征;但对此类动脉瘤的治疗效果仍不清楚。本研究旨在比较 Surpass Streamline、Pipeline Flex 和 Tubridge 装置引起的血流动力学改变,并探索治疗胎儿后交通动脉瘤的可能策略。虚拟部署了三个 FD,并根据计算流体动力学进行了血流动力学分析。比较了每个 FD 与未处理模型(对照组)之间的血流动力学参数,包括囊平均速度幅值(Velocity)、高流量(HFV)和壁剪应力(WSS)。结果与对照组相比,Surpass 使血流明显减少。在病例 1 中,流速、HFV 和 WSS 分别降低了 51.6%、78.1% 和 64.3%。在病例 2 中,流速、高频变压和 WSS 分别降低了 48.0%、81.1% 和 65.3%。管桥的血液动力学参数变化略大于管道。此外,我们的分析表明,金属覆盖与 WSS、Velocity 和 HFV 相关。结论与 Pipeline 和 Tubridge 相比,Surpass 能最大程度地降低血流动力学参数,可能对胎儿后交通动脉瘤有效。虚拟 FD 部署和计算流体动力学分析可用于预测治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hemodynamic alterations of flow diverters on aneurysms at the fetal posterior communicating artery: A simulation study using CFD to compare the surpass streamline, pipeline flex, and tubridge devices

Purpose

Traditional flow diverters (FDs) for treating aneurysms at the fetal posterior communicating artery are unsatisfactory. Surpass Streamline is a novel FD with different mesh characteristics; however, the outcomes for such aneurysms remain unclear. This study aimed to compare hemodynamic alterations induced by Surpass Streamline, Pipeline Flex, and Tubridge devices and explore possible strategies for aneurysms at the fetal posterior communicating artery.

Methods

Two simulated aneurysms (Case 1, Case 2) were constructed from digital subtraction angiography (DSA). The three FDs were virtually deployed, and hemodynamic analysis based on computational fluid dynamics was performed. Hemodynamic parameters, including the sac-averaged velocity magnitude (Velocity), high-flow volume (HFV), and wall shear stress (WSS), were compared between each FD and the untreated model (control). Surpass Streamline was performed in real life for two aneurysms and the clinical outcomes were collected for analysis.

Results

Compared to the control, the Surpass resulted in the most significant reduction in flow. In Case 1, the Velocity, HFV, and WSS were reduced by 51.6%, 78.1%, and 64.3%, respectively. In Case 2, the Velocity, HFV, and WSS were reduced by 48.0%, 81.1%, and 65.3%, respectively. Tubridge showed slightly larger changes in hemodynamic parameters than Pipeline. In addition, our analysis suggested that metal coverage was correlated with the WSS, Velocity, and HFV. The postoperative DSA showed that the aneurysm was nearly occluded in Case 1 and decreased in Case 2.

Conclusion

Compared to that with the Pipeline and Tubridge, the Surpass resulted in the greatest reduction in hemodynamic parameters and might be effective for aneurysms at the fetal posterior communicating artery. Virtual FD deployment and computational fluid dynamics analysis may be used to predict the treatment outcomes.

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来源期刊
Journal of Neuroradiology
Journal of Neuroradiology 医学-核医学
CiteScore
6.10
自引率
5.70%
发文量
142
审稿时长
6-12 weeks
期刊介绍: The Journal of Neuroradiology is a peer-reviewed journal, publishing worldwide clinical and basic research in the field of diagnostic and Interventional neuroradiology, translational and molecular neuroimaging, and artificial intelligence in neuroradiology. The Journal of Neuroradiology considers for publication articles, reviews, technical notes and letters to the editors (correspondence section), provided that the methodology and scientific content are of high quality, and that the results will have substantial clinical impact and/or physiological importance.
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