Finite Element Simulation of Double-Stent Parallel Thrombectomy at Y-Shaped Bifurcation of Internal Carotid Artery / 医用生物力学

Objective To study the process of single stent and double-stent thrombectomy at the Y-shaped bifurcation of the ideal internal carotid artery by finite element simulation, analyze the stent-thrombus-vessel interaction during the thrombectomy process based on the simulation results, and provide guidance for improving the effect of stent thrombectomy at the bifurcation. Methods The CAD software was used to build the model and the finite element analysis software was used to simulate the process of single stent and double-stent thrombectomy. Results Thrombectomy was unsuccessful in single stent model and successful in double-stent model, and the maximum stress of thrombus during embolus retrieval was twice that of single stent, the maximum strain was 1.12 times that of single stent, and the maximum contact pressure on the surface of vessel was approximately twice that of single stent. Conclusions Double Solitaire stents can effectively prevent thrombus displacement at the bifurcation and successfully retrieve the thrombus, but there is a risk of fracture due to the high stress level in the middle section of the thrombus. The contact pressure of the vessel on the anterior artery side is higher during thrombectomy, and the risk of vessel damage is greater. Therefore, it is necessary to optimize the design of the stent-retriever to improve its flexibility.

Surgical management in rerupture of internal carotid aneurysm after recanalization treated-coil: a case report

Introduction: Little is known about incidence, anatomical and clinical characteristics and results of endovascular treatment of the internal carotid artery (ICA) aneurysms. This type of the aneurysms can be approached by surgical with low morbidity and mortality. Clinical presentation: a 48-year-old woman submitted an endovascular embolization treatment in 2005, and in 2009 presents a new bleeding. The angiography shows that the same aneurysm was ruptured and a surgical repair was proposed. The surgical management shows detachable coils in the brain parenchyma. Conclusion: Some endovascular surgeons preferred the less invasive procedure (endovascular treatment) for intracranial aneurysms, but the surgical repair still remains the best choice for definitive treatment for intracranial aneurysms.