Wiśniewski Karol, Tyfa Zbigniew, Tomasik Bartłomiej, Reorowicz Piotr, Bobeff Ernest J, Posmyk Bartłomiej J, Hupało Marlena, Stefańczyk Ludomir, Jóźwik Krzysztof, Jaskólski Dariusz J
Department of Neurosurgery and Neurooncology, Medical University of Lodz, Kopcińskiego 22, 90-153 Lodz, Poland.
Institute of Turbomachinery, Medical Apparatus Division, Lodz University of Technology, Wolczanska 219/223, 90-924 Lodz, Poland.
J Pers Med. 2021 Aug 14;11(8):793. doi: 10.3390/jpm11080793.
The aim of our study was to identify risk factors for recanalization 6 months after coil embolization using clinical data followed by computational fluid dynamics (CFD) analysis.
Firstly, clinical data of 184 patients treated with coil embolization were analyzed retrospectively. Secondly, aneurysm models for high/low recanalization risk were generated based on ROC curves and their cut-off points. Afterward, CFD was utilized to validate the results.
In multivariable analysis, aneurysm filling during the first embolization was an independent risk factor whilst packing density was a protective factor of recanalization after 6 months in patients with aSAH. For patients with unruptured aneurysms, packing density was found to be a protective factor whilst the aneurysm neck size was an independent risk factor. Complex flow pattern and multiple vortices were associated with aneurysm shape and were characteristic of the high recanalization risk group.
Statistical analysis suggested that there are various factors influencing recanalization risk. Once certain values of morphometric parameters are exceeded, a complex flow with numerous vortices occurs. This phenomenon was revealed due to CFD investigations that validated our statistical research. Thus, the complex flow pattern itself can be treated as a relevant recanalization predictor.
我们研究的目的是利用临床数据，随后进行计算流体动力学（CFD）分析，来确定弹簧圈栓塞术后6个月再通的危险因素。
首先，对184例行弹簧圈栓塞治疗的患者的临床数据进行回顾性分析。其次，根据ROC曲线及其截断点生成高/低再通风险的动脉瘤模型。随后，利用CFD验证结果。
在多变量分析中，首次栓塞时动脉瘤的充盈情况是一个独立的危险因素，而填塞密度是aSAH患者6个月后再通的一个保护因素。对于未破裂动脉瘤患者，填塞密度是一个保护因素，而动脉瘤颈大小是一个独立的危险因素。复杂的血流模式和多个涡流与动脉瘤形状相关，是高再通风险组的特征。
统计分析表明，有多种因素影响再通风险。一旦形态学参数超过特定值，就会出现带有大量涡流的复杂血流。由于CFD研究验证了我们的统计研究，这一现象得以揭示。因此，复杂的血流模式本身可被视为一个相关的再通预测指标。
