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Quantification of hemodynamic changes induced by virtual placement of multiple stents across a wide -necked Basilar trunk aneurysm

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journal contribution
posted on 31.10.2019, 12:24 by Minsuok KimMinsuok Kim, Elad I Levy, Hui Meng, L Nelson Hopkins
OBJECTIVE: The porous intravascular stents that are currently available may not cause complete aneurysm thrombosis and may therefore fail to provide durable protection against aneurysm rupture when used as a sole treatment modality. The goal of this study was to quantify the effects of porous stents on aneurysm hemodynamics using computational fluid dynamics. METHODS: The geometry of a wide-necked saccular basilar trunk aneurysm was reconstructed from a patient’s computed tomographic angiography images. Three commercial stents (Neuroform2; Boston Scientific/Target, San Leandro, CA; Wingspan; Boston Scientific, Fremont, CA; and Vision; Guidant Corp., Santa Clara, CA) were modeled. Various combinations of one to three stents were virtually conformed to fit into the vessel lumen and placed across the aneurysm orifice. An unstented aneurysm served as a control. Computational fluid dynamics analysis was performed to calculate the hemodynamic parameters considered important in aneurysm pathogenesis and thrombosis for each of the models. RESULTS: The complex flow pattern observed in the unstented aneurysm was suppressed by stenting. Stent placement lowered the wall shear stress in the aneurysm, and this effect was increased by additional stent deployment. Turnover time was moderately increased after single- and double-stent placement and markedly increased after three stents were placed. The influence of stent design on hemodynamic parameters was more significant in double-stented models than in other models. CONCLUSION: Aneurysm hemodynamic parameters were significantly modified by placement of multiple stents. Because the associated modifications may be helpful as well as harmful in terms of rupture risk, use of this technique requires careful consideration.

Funding

National Institutes of Health Grants NS-047242 (HM), NS-43924 (MK, HM), and EB-002873 (MK, HM)

National Science Foundation Grant BES-0302389 (MK, HM)

History

School

  • Mechanical, Electrical and Manufacturing Engineering

Published in

Neurosurgery

Volume

61

Issue

6

Pages

1305 - 1313

Publisher

Oxford University Press (OUP)

Version

AM (Accepted Manuscript)

Publisher statement

This is a pre-copyedited, author-produced version of an article accepted for publication in Neurosurgery following peer review. The version of record Kin, M. … et al., (2007). Quantification of hemodynamic changes induced by virtual placement of multiple stents across a wide -necked Basilar trunk aneurysm. Neurosurgery, 61(6), pp.1305–1313 is available online at: https://doi.org/10.1227/01.neu.0000306110.55174.30

Publication date

2007-12-01

Copyright date

2007

ISSN

0148-396X

eISSN

1524-4040

Language

en

Depositor

Dr Minsuok Kim Deposit date: 28 October 2019