Tang Yudi, Chen Peike, Lv Jian, Wei Haining, Wang Xiaoyan, Feng Junqiang, Jiang Yuhua, Liu Peng, Li Youxiang, Yang Yunna
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Int J Med Sci. 2025 Jun 20;22(12):3044-3052. doi: 10.7150/ijms.115452. eCollection 2025.
Flow-diverting stents (FDS) are widely used in the treatment of intracranial aneurysms. During treatment, many side branches-especially small ones-are inevitably covered, leading to narrowing and impaired blood flow. However, the factors contributing to stenosis have not been thoroughly studied.
A retrospective cross-sectional study was conducted. Digital subtraction angiography (DSA) images and clinical data were collected. Two neuroradiologists independently assessed arterial geometry characteristics. Participants were divided into a narrow group and unchanged group based on preoperative and follow-up data, and the characteristics of the two groups were compared. A simplified model was established to evaluate changes in wall shear stress (WSS) before and after FDS implantation.
The distal small branch diameter in the unchanged group was significantly smaller than that in the narrow group. The ratio of distal to proximal diameters of the ophthalmic artery (DPOA) in the narrow group was concentrated between 0.9 and 1.1. WSS in the proximal ophthalmic artery region (POAR) increased with larger distal ophthalmic artery diameters, both pre- and post-operatively. The difference between preoperative and postoperative WSS also increased with higher DPOA. After FDS implantation, the WSS of most jailed ophthalmic arteries in POAR decreased. However, in cases with proximal stenosis, the DPOA of these jailed ophthalmic arteries was primarily concentrated between 0.9 and 1.1. This pattern may occur because WSS decreased from high level to low level.
血流导向支架（FDS）广泛应用于颅内动脉瘤的治疗。在治疗过程中，许多分支血管，尤其是小分支血管不可避免地被覆盖，导致血管狭窄和血流受损。然而，导致狭窄的因素尚未得到充分研究。
进行一项回顾性横断面研究。收集数字减影血管造影（DSA）图像和临床数据。两名神经放射科医生独立评估动脉几何特征。根据术前和随访数据将参与者分为狭窄组和未改变组，并比较两组的特征。建立一个简化模型来评估FDS植入前后壁面切应力（WSS）的变化。
未改变组的远端小分支直径明显小于狭窄组。狭窄组眼动脉远端与近端直径之比（DPOA）集中在0.9至1.1之间。术前和术后，眼动脉近端区域（POAR）的WSS均随着眼动脉远端直径的增大而增加。术前和术后WSS的差异也随着DPOA的升高而增大。FDS植入后，POAR中大多数被覆盖眼动脉的WSS降低。然而，在近端狭窄的病例中，这些被覆盖眼动脉的DPOA主要集中在0.9至1.1之间。这种模式可能是因为WSS从高水平降至低水平而出现的。
