ABSTRACT
Objective To comprehensively consider the effect of low diverter (FD) implantation on aneurysmal sac and its branches, so as to provide references for making a more reasonable surgical strategy for intracranial aneurysm embolization in clinical practice. Methods Based on computational fluid dynamics (CFD) method, the FD implantation procedure was simulated by using porous media model innovatively. Changes in hemodynamic parameters of aneurysmal sac and side branch with different diameters before and after FD implantation were compared and analyzed, such as blood flow field, velocity, wall pressure and wall shear stress (WSS). Results FD changed the hemodynamic characteristics of aneurysms. The blood flow velocity decreased significantly. The WSS on aneurysmal neck increased, while the difference of WSS between proximal and distal cervical area reduced conversely. Different side branch diameters of vessels had different effects on hemodynamic characteristic changes. The larger diameter would cause the greater blood flow reduction in side branch after FD implantation, but the decrease in velocity of aneurysmal sac and pressure on aneurysmal roof became smaller simultaneously. Meanwhile, the increase of WSS on aneurysmal neck was inversely proportional to the diameter of side branch. Conclusions The larger branch diameter of vessels would cause the worse effect of FD embolization therapy for intracranial aneurysm, worse atherosclerosis improvements and greater possibilities of branch occlusion or other ischemic complications. Doctors should pay more attention to such cases in FD interventional intravascular embolization in clinic.
ABSTRACT
Objective To simulate the hemodynamic effects of different flow diverters (FD) parameters by using computational fluid dynamics (CFD) technology, so as to develop a more reasonable FD embolization strategy before operation. Methods The porous media model was used to simulate the process of FD implantation into aneurysms, and the initial values of its own unique porous media momentum source parameters (permeability and inertial resistance) were calculated for a specific FD (Tubridge).The changes of hemodynamic parameters such as blood flow velocity, wall shear stress (WSS), volume flow and pressure of aneurysm-roof were compared under different situations (initial values of 80%, 90%, 100%, 110% and 120%), and the sensitivity analysis on hemodynamic parameters of patient-specific intracranial aneurysms (IA) for the porous media model was further conducted. Results The sensitivity of IA hemodynamic parameters to the permeability of porous media model was as follows: WSSparent-artery＞WSSaneurysm＞paneurysmal-roof, but the sensitivity to inertia resistance was relatively lower. Conclusions By using the porous media model, different metal coverages (MC) of FD could be simulated by choosing different permeability parameters, so it is necessary to adjust specific permeability settings during modeling of FD with different MC.