血流导向支架治疗颅内动脉瘤的流体动力学:多个几何参数的影响

Fluid dynamics in intracranial aneurysms treated with flow-diverting stents: effect of multiple geometrical parameters.

作者信息

Chassagne Fanette, Barbour Michael C, Levitt Michael R, Aliseda Alberto

机构信息

SAINBIOSE INSERM U1059, Mines Saint-Étienne, F-42023 Saint-Étienne, France.

Department of Mechanical Engineering, University of Washington, Seattle, WA 98105, USA.

出版信息

J Fluid Mech. 2023 Oct 23;973. doi: 10.1017/jfm.2023.763.

Abstract

Characterizing the haemodynamics in intracranial aneurysms is of high interest as it impacts aneurysm growth, rupture and treatment, especially with flow-diverting stents (FDS). Flow in these geometries is known to depend on the Dean, Reynolds and Womersley numbers, , but is also influenced by geometrical parameters such as the sac shape or the size of the opening. Via particle image velocimetry, this parametric study aimed at evaluating the combined effects of , and the geometry of the aneurysmal sac on the haemodynamics before and after treatment with FDS. Eight ellipsoidal idealized aneurysm models were created with two curvatures of the parent vessel, two aspect ratios of the sac and two neck sizes. Before treatment, a single counter-rotating vortex, whose strength increases with and , as well as with the neck size and the aspect ratio, was observed in the sac for all but one geometry. After treatment with FDS, four different flow topologies were observed, depending on the geometry: no separation, separation for part of the cycle, two opposing vortices or a single counter-rotating vortex. A linear model with interaction revealed the predominant effect of and the curvature of the parent vessel on the haemodynamics before and after treatment. This work once more demonstrated the primary role of haemodynamics in the treatment of intracranial aneurysms with FDS. Future work will consider the complexity of patient-specific geometries, and their effects on both the haemodynamics in the sac and the porosity of the FDS.

摘要

颅内动脉瘤血流动力学特征备受关注,因为它会影响动脉瘤的生长、破裂及治疗,尤其是在使用血流导向支架(FDS)时。已知这些几何形状中的血流取决于迪恩数、雷诺数和沃默斯利数,但也受几何参数影响,如瘤囊形状或开口大小。通过粒子图像测速技术,这项参数研究旨在评估迪恩数、雷诺数以及瘤囊几何形状对使用FDS治疗前后血流动力学的综合影响。创建了八个椭圆形理想化动脉瘤模型,具有两种母血管曲率、两种瘤囊纵横比和两种颈部尺寸。治疗前,除一种几何形状外,在所有瘤囊中均观察到一个单一的反向旋转涡流,其强度随迪恩数、雷诺数以及颈部尺寸和纵横比的增加而增大。使用FDS治疗后,根据几何形状观察到四种不同的流动拓扑结构:无分离、部分周期分离、两个相反的涡流或一个单一的反向旋转涡流。一个具有交互作用的线性模型揭示了迪恩数和母血管曲率在治疗前后对血流动力学的主要影响。这项工作再次证明了血流动力学在使用FDS治疗颅内动脉瘤中的首要作用。未来的工作将考虑患者特异性几何形状的复杂性,以及它们对瘤囊内血流动力学和FDS孔隙率的影响。

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