Background: The concept of a Hybrid Angio-Surgical Suite (HASS) has emerged as a solution to the complexity of cerebrovascular surgery and the need for immediate intraoperative feedback. When to use it, what cases are...Background: The concept of a Hybrid Angio-Surgical Suite (HASS) has emerged as a solution to the complexity of cerebrovascular surgery and the need for immediate intraoperative feedback. When to use it, what cases are suitable for its use, who can use it and how to use it remain debatable. Objective: Provide the information regarding the application of the HASS for hospital, neurosurgeon and interventionalist. Methods: We review the literatures of case reports and studies on the use of the hybrid angio-sugical suite along with application of HASS in our own practice. Results: Indications for using HASS on different types of cerebral vascular disease, including cerebral aneurysm, AVM, DAVF, carotid and vertebral stenosis/occlusion, are addressed. The application of HASS for other non-cerebral vascular diseases, such as trauma, spine and skullbase cases, is reviewed and discussed. Conclusion: HASS has made many surgical procedures safer and many difficult or previously untreatable conditions much more tractable and cost-effective. Other than used in cerebral vascular disease, HASS has much more applications, such as trauma, spine and other neurosurgical diseases.展开更多
Flow diverter intervention is a cutting-edge treatment for intracranial aneurysms by altering the flow field and reducing the pressure in the aneurysm sac.However,the rupture rate and complications rate are still high...Flow diverter intervention is a cutting-edge treatment for intracranial aneurysms by altering the flow field and reducing the pressure in the aneurysm sac.However,the rupture rate and complications rate are still high.In this study,a new design of flow diverter based on Bernoulli’s equation was proposed and hemodynamics evaluation of it was conducted.The numerical model of a patient specific internal carotid aneurysm was established based on computed tomography scan images(Model C).The aneurysm models with normal diverter(ND)and local stenosed diverter(LSD)were modified from the patient-specific model.The blood flow characteristics were obtained and analyzed by numerical simulation while the in vitro experiments were conducted using three-dimensional printed silicone models and pressure measurement system.In both ND and LSD models,the blood flow into the aneurysm have been significantly blocked by the diverters and the pressure in the aneurysm sac have been decreased.The pressure drop and the wall shear stress on the aneurysm wall in the LSD model are higher than that in the ND model.The oscillatory shear index and relative residence time in the aneurysm wall of LSD are lower than that in the ND model.The pressure measurement in the vitro experiment also qualitatively verified the results of pressure comparison in the numerical simulation.In conclusion,the simulation results and in vitro experiments verified that diverter can certainly reduce the pressure in the aneurysm,and the newly design diverter with local stenosis can strengthening this effect.展开更多
文摘Background: The concept of a Hybrid Angio-Surgical Suite (HASS) has emerged as a solution to the complexity of cerebrovascular surgery and the need for immediate intraoperative feedback. When to use it, what cases are suitable for its use, who can use it and how to use it remain debatable. Objective: Provide the information regarding the application of the HASS for hospital, neurosurgeon and interventionalist. Methods: We review the literatures of case reports and studies on the use of the hybrid angio-sugical suite along with application of HASS in our own practice. Results: Indications for using HASS on different types of cerebral vascular disease, including cerebral aneurysm, AVM, DAVF, carotid and vertebral stenosis/occlusion, are addressed. The application of HASS for other non-cerebral vascular diseases, such as trauma, spine and skullbase cases, is reviewed and discussed. Conclusion: HASS has made many surgical procedures safer and many difficult or previously untreatable conditions much more tractable and cost-effective. Other than used in cerebral vascular disease, HASS has much more applications, such as trauma, spine and other neurosurgical diseases.
基金This work was supported by the National Key Research and Development Plan of China(2017YFB0702501)the National Natural Science Foundation of China(No.11872096,11772036,31870940),the “111” Project(B13003).
文摘Flow diverter intervention is a cutting-edge treatment for intracranial aneurysms by altering the flow field and reducing the pressure in the aneurysm sac.However,the rupture rate and complications rate are still high.In this study,a new design of flow diverter based on Bernoulli’s equation was proposed and hemodynamics evaluation of it was conducted.The numerical model of a patient specific internal carotid aneurysm was established based on computed tomography scan images(Model C).The aneurysm models with normal diverter(ND)and local stenosed diverter(LSD)were modified from the patient-specific model.The blood flow characteristics were obtained and analyzed by numerical simulation while the in vitro experiments were conducted using three-dimensional printed silicone models and pressure measurement system.In both ND and LSD models,the blood flow into the aneurysm have been significantly blocked by the diverters and the pressure in the aneurysm sac have been decreased.The pressure drop and the wall shear stress on the aneurysm wall in the LSD model are higher than that in the ND model.The oscillatory shear index and relative residence time in the aneurysm wall of LSD are lower than that in the ND model.The pressure measurement in the vitro experiment also qualitatively verified the results of pressure comparison in the numerical simulation.In conclusion,the simulation results and in vitro experiments verified that diverter can certainly reduce the pressure in the aneurysm,and the newly design diverter with local stenosis can strengthening this effect.
