2026-04-17T06:21:18Zhttps://recercat.cat/oai/request

oai:recercat.cat:10230/591452025-12-20T16:55:42Zcom_2072_6col_2072_452952

urn:hdl:10230/59145 Intra-aneurysmal pressure and flow changes induced by flow diverters: relation to aneurysm size and shape Larrabide, Ignacio, 1978- Aguilar, María Laura Morales, Hernán G. Geers, Adrianus Johannes Kulcsár, Zsolt Rüfenacht, Daniel Frangi Caregnato, Alejandro Aneurismes cerebrals Imatgeria tridimensional en medicina Hemodinàmica Background and purpose: Effects of blood flow modification by flow diverters are observed to lead often to aneurysm thrombosis and reverse remodeling. For this process, to further understand the potential roles of intra-aneurysmal blood pressure changes and aneurysm morphologies, 23 patients were studied by numeric simulation. Materials and methods: 3D imaging of aneurysms of different sizes and shapes, all located at the supraclinoid segment of the ICA (n = 23), was prepared for CFD simulations. Hemodynamic variables were calculated for conditions before and after virtual FD implantation, reconstituting a vessel wall scaffold across the aneurysm neck. WSS, velocity, residence time, turnover time, and intra-aneurysmal pressure were assessed statistically. Results: After placement of FDs, significant reductions inside the aneurysm were observed for most hemodynamic variables (P < .01) except mean intra-aneurysmal pressures. For minimum/maximum intra-aneurysmal pressure values, small but significant changes were found; however, they were considered too small to be of relevance. Conclusions: Calculations in 23 cases did not reveal significant intra-aneurysmal mean or peak pressure changes, indicating a minor role of pressure changes in the rare event of secondary ruptures after FD use. Other hemodynamic variables (WSS and velocity) exhibited more significant changes, indicating their role in intra-aneurysmal thrombus formation. Size-dependent, significantly higher reduction in WSS (P = .069) and velocity (P = .013) was observed in small aneurysms compared with larger ones. When it came to shape, there were significantly higher reductions in WSS (P = .055) and velocity (P = .065) and a significantly higher increase in turnover time in fusiform aneurysms compared with saccular aneurysms. This research has been partially funded by the Industrial and Technological Development Center (CDTI) under the CENIT-CDTEAM and CENIT-cvREMOD programs, the European Commission project @neurIST (IST-2005-027703), and Philips Healthcare. 2024-02-19T10:09:16Z 2024-02-19T10:09:16Z 2013 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion American Journal of Neuroradiology. 2013 Apr 1;34(4):816-22 info:eu-repo/grantAgreement/EC/FP6/027703 © 2013 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org. info:eu-repo/semantics/openAccess American Society of Neuroradiology