大脑中动脉分叉部动脉瘤的治疗:新型 Contour 装置与传统血流导向装置的计算机模拟比较。

Treatment for middle cerebral artery bifurcation aneurysms: in silico comparison of the novel Contour device and conventional flow-diverters.

机构信息

Department of Mechanical Engineering, University College London, London, UK.

Department of Interventional Neuroradiology, The Royal London Hospital, London, UK.

出版信息

Biomech Model Mechanobiol. 2024 Aug;23(4):1149-1160. doi: 10.1007/s10237-024-01829-3. Epub 2024 Apr 8.

Abstract

Endovascular treatment has become the standard therapy for cerebral aneurysms, while the effective treatment for middle cerebral artery (MCA) bifurcation aneurysms remains a challenge. Current flow-diverting techniques with endovascular coils cover the aneurysm orifice as well as adjacent vessel branches, which may lead to branch occlusion. Novel endovascular flow disruptors, such as the Contour device (Cerus Endovascular), are of great potential to eliminate the risk of branch occlusion. However, there is a lack of valid comparison between novel flow disruptors and conventional (intraluminal) flow-diverters. In this study, two in silico MCA bifurcation aneurysm models were treated by specific Contour devices and flow-diverters using fast-deployment algorithms. Computational fluid dynamic simulations were used to examine the performance and efficiency of deployed devices. Hemodynamic parameters, including aneurysm inflow and wall shear stress, were compared among each Contour device, conventional flow-diverter, and untreated condition. Our results show that the placement of devices can effectively reduce the risk of aneurysm rupture, while the deployment of a Contour device causes more flow reduction than using flow-diverters (e.g. Silk Vista Baby). Besides, the Contour device presents the flow diversion capability of targeting the aneurysm neck without occluding the daughter vessel. In summary, the in silico aneurysm models presented in this study can serve as a powerful pre-planning tool for testing new treatment techniques, optimising device deployment, and predicting the performance in patient-specific aneurysm cases. Contour device is proved to be an effective treatment of MCA bifurcation aneurysms with less daughter vessel occlusion.

摘要

血管内治疗已成为脑动脉瘤的标准治疗方法,而治疗大脑中动脉(MCA)分叉部动脉瘤仍然是一个挑战。目前的血管内血流导向技术用血管内线圈覆盖动脉瘤口和相邻的血管分支,这可能导致分支闭塞。新型的血管内血流破坏装置,如 Contour 装置(Cerus Endovascular),具有消除分支闭塞风险的巨大潜力。然而,新型血流破坏装置与传统(管腔内)血流导向器之间缺乏有效的比较。在这项研究中,使用快速部署算法对两个 MCA 分叉部动脉瘤模型进行了特定的 Contour 装置和血流导向器治疗。计算流体动力学模拟用于检查已部署装置的性能和效率。比较了每个 Contour 装置、传统血流导向器和未处理条件下的动脉瘤流入和壁切应力等血流动力学参数。我们的结果表明,装置的放置可以有效地降低动脉瘤破裂的风险,而 Contour 装置的放置比使用血流导向器(如 Silk Vista Baby)会导致更多的血流减少。此外,Contour 装置具有针对动脉瘤颈部的血流导向能力,而不会闭塞子血管。总之,本研究中提出的计算动脉瘤模型可以作为一种强大的术前规划工具,用于测试新的治疗技术、优化装置的部署,并预测特定患者的动脉瘤病例中的性能。Contour 装置被证明是治疗 MCA 分叉部动脉瘤的有效方法,可减少对子血管的闭塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433d/11341747/c7fd9549f2cf/10237_2024_1829_Fig1_HTML.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索