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采用血流导向装置治疗颅内动脉瘤的计算流体动力学分析:病例报告。

Computational fluid dynamics analysis of intracranial aneurysms treated with flow diverters: A case report.

机构信息

Department of Neurosurgery, Lanzhou University Second Hospital, 80, Cuiyingmen Road, Chengguan District, 730030 Lanzhou City, Gansu Province, China.

School of Clinical Medicine, Gansu University of Chinese Medicine, 730030 Lanzhou, China.

出版信息

Neurochirurgie. 2022 Feb;68(2):235-238. doi: 10.1016/j.neuchi.2021.03.007. Epub 2021 Mar 23.

Abstract

INTRODUCTION

Intracranial aneurysms (IAs) are localized dilatations of intracranial arteries due to weaknesses of the endothelial layer. IAs may be treated by flow diverters (FDs), alternatively to stents and coils combination. FD is a method for the treatment of IAs especially for large, wide-necked or fusiform aneurysms. In this case report, we described a 65-year-old woman with IA who were treated by FD.

CASE PRESENTATION

A 65-year-old woman was diagnosed with a giant aneurysm at the posterior inferior cerebellar artery segment of the left internal carotid artery. Then based on the computed tomography data of this woman, aneurysm vascular stent model was constructed before and after FD, and internal pressure, velocity, wall shear stress (WSS) of aneurysms were determined by CFD analysis. Standard boundary conditions were applied. It was found that a single FD stent and double FD stents decreased the blood flow and WSS of aneurysm. The effect of single FD stent+30% filling on blood flow was more obvious, but the aneurysm rupture was caused by excessive coil packing. So, a single stent+10% coil packing rate was the best option for treating aneurysms.

CONCLUSIONS

CFD analysis for flow velocity and WSS have protection on aneurysms.

摘要

简介

颅内动脉瘤(IA)是由于血管内皮层的弱点导致的颅内动脉局部扩张。IA 可通过血流导向装置(FD)治疗,可替代支架和线圈联合治疗。FD 是一种治疗 IA 的方法,特别是对于大、宽颈或梭形动脉瘤。在本病例报告中,我们描述了一位 65 岁女性,其左侧颈内动脉后下小脑动脉段存在 IA,采用 FD 治疗。

病例介绍

一位 65 岁女性被诊断为左侧颈内动脉后下小脑动脉段的巨大动脉瘤。然后根据该女性的 CT 数据,在 FD 治疗前后构建了动脉瘤血管支架模型,并通过 CFD 分析确定了动脉瘤的内压、速度和壁面剪切应力(WSS)。应用了标准边界条件。结果发现,单个 FD 支架和双 FD 支架减少了动脉瘤的血流和 WSS。单 FD 支架+30%充盈对血流的影响更为明显,但由于过度填塞线圈导致动脉瘤破裂。因此,单支架+10%的线圈填塞率是治疗动脉瘤的最佳选择。

结论

CFD 分析血流速度和 WSS 对动脉瘤具有保护作用。

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