Mantilla Daniel, Berod Alain, Ortiz Andrés F, Vera Daniela D, Nicoud Franck, Costalat Vincent
Interventional Radiology Department, Fundación oftalmológica de Santander - Clínica Ardila Lülle. Floridablanca, Colombia.
Interventional Radiology Department, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia.
Interv Neuroradiol. 2025 Jun;31(3):315-323. doi: 10.1177/15910199231152514. Epub 2023 Feb 3.
IntroductionThe Woven EndoBridge device (WEB) was developed as an alternative to treat Wide-Necked bifurcation aneurysms. It has proven to be effective and safe, however, cases of recanalization have been reported. The purpose of this study was to evaluate and quantify hemodynamic parameters and indexes with CFD of the intracranial aneurysms before and after WEB simulation and to establish their relationship to complete occlusion.Materials and methodsUsing the heterogeneous model based on the marching cubes algorithm, we created 3D representations of 27 bifurcated intracranial aneurysms treated with the single-layer WEB device to evaluate hemodynamics parameters with CFD, calculated with and without the WEB.ResultsWe observed a lower treatment entry concentration indices (ICI) (2.12 ± 1.31 versus 3.14 ± 0.93, p-value: 0.029) previous to placement of WEB and higher pre-treatment FN (7.56 ± 5.92 versus 3.35 ± 1.51, p-value: 0.018) and post-treatment FN (5.34 ± 5.89 versus 1.99 ± 0.83, p-value: 0.021) for cases with successful occlusions. Lower post-treatment SRa (197.81 ± 221.29 versus 80.02 ± 45.25, p-value: 0.044) and higher pre (0.11 ± 0.07 versus 0.25 ± 0.19, p-value: 0.011) and post-treatment MATT (0.69 ± 1.23 versus 1.02 ± 0.46, p-value: 0.006) were observed in non-occluded cases.ConclusionsIn our CFD analysis of the hemodynamic parameters of IA, we found lower ICI before the placement of the WEB device and higher FN pre- and post-treatment for cases with successful occlusions. Non-occluded cases had lower post-treatment SRa and higher pre-treatment and post-treatment MATT.
引言
编织型血管内桥接装置（WEB）被开发出来作为治疗宽颈分叉动脉瘤的一种替代方法。它已被证明是有效且安全的，然而，再通病例也有报道。本研究的目的是通过计算流体动力学（CFD）评估和量化颅内动脉瘤在WEB模拟前后的血流动力学参数和指标，并确定它们与完全闭塞的关系。
材料和方法
使用基于移动立方体算法的非均匀模型，我们创建了27个用单层WEB装置治疗的分叉颅内动脉瘤的三维模型，以通过CFD评估血流动力学参数，分别计算有和没有WEB时的参数。
结果
我们观察到，对于成功闭塞的病例，在放置WEB之前治疗入口浓度指数（ICI）较低（2.12±1.31对3.14±0.93，p值：0.029），治疗前的颈内动脉分叉处血流分数（FN）较高（7.56±5.92对3.35±1.51，p值：0.018）以及治疗后的FN较高（5.34±5.89对1.99±0.83，p值：0.021）。对于未闭塞的病例，观察到治疗后的相对血流速度（SRa）较低（197.81±221.29对80.02±45.25，p值：0.044），治疗前（0.11±0.07对0.25±0.19，p值：0.011）和治疗后的平均通过时间（MATT）较高（0.69±1.23对1.02±0.46，p值：0.006）。
结论
在我们对颅内动脉瘤血流动力学参数的CFD分析中，我们发现对于成功闭塞的病例，在放置WEB装置之前ICI较低，治疗前和治疗后的FN较高。未闭塞的病例治疗后的SRa较低，治疗前和治疗后的MATT较高。
