Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Xueyuan street 1068, Shenzhen University Town, Nanshan District, Shenzhen, 518000, China.
Department of Neurosurgery, Shenzhen Second People's Hospital, Sungang West Road 3002, Futian District, Guangdong, 510000, China.
Int J Comput Assist Radiol Surg. 2024 Jun;19(6):1175-1183. doi: 10.1007/s11548-024-03124-z. Epub 2024 Apr 15.
The internal carotid artery (ICA) is a region with a high incidence for small- and medium-sized saccular aneurysms. However, the treatment relies heavily on the surgeon's experience to achieve optimal outcome. Although the finite element method (FEM) and computational fluid dynamics can predict the postoperative outcomes, due to the computational complexity of traditional methods, there is an urgent need for investigating the fast but versatile approaches related to numerical simulations of flow diverters (FDs) deployment coupled with the hemodynamic analysis to determine the treatment plan.
We collected the preoperative and postoperative data from 34 patients (29 females, 5 males; mean age 55.74 ± 9.98 years) who were treated with a single flow diverter for small- to medium-sized intracranial saccular aneurysms on the ICA. The constraint-based virtual deployment (CVD) method is proposed to simulate the FDs expanding outward along the vessel centerline while be constrained by the inner wall of the vessel.
The results indicate that there were no significant differences in the reduction rates of wall shear stress and aneurysms neck velocity between the FEM and methods. However, the solution time of CVD was greatly reduced by 98%.
In the typical location of small- and medium-sized saccular aneurysms, namely the ICA, our virtual FDs deployment simulation effectively balances the computational accuracy and efficiency. Combined with hemodynamics analysis, our method can accurately represent the blood flow changes within the lesion region to assist surgeons in clinical decision-making.
颈内动脉（ICA）是小-中型囊状动脉瘤高发区域。然而，其治疗很大程度上依赖于外科医生的经验，以达到最佳效果。尽管有限元方法（FEM）和计算流体动力学可以预测术后结果，但由于传统方法的计算复杂性，迫切需要研究与血流导向装置（FD）展开相关的快速而通用的方法，同时结合血流动力学分析来确定治疗方案。
我们收集了 34 名接受单一血流导向装置治疗 ICA 小-中型囊状动脉瘤的患者（29 名女性，5 名男性；平均年龄 55.74±9.98 岁）的术前和术后数据。提出了基于约束的虚拟展开（CVD）方法来模拟 FD 沿血管中心线向外扩展，同时受到血管内壁的约束。
结果表明，FEM 和方法在壁切应力和动脉瘤颈部速度的降低率方面没有显著差异。然而，CVD 的求解时间大大减少了 98%。
在小-中型囊状动脉瘤的典型位置，即 ICA，我们的虚拟 FD 展开模拟有效地平衡了计算精度和效率。结合血流动力学分析，我们的方法可以准确地表示病变区域内的血流变化，以协助外科医生进行临床决策。
