Hemodynamic characteristics such as blood velocity,blood pressure,flow impingement,wall shear stress and oscillatory shear index are considered to play important roles in the initiation,growth,rupture and recurrence o...Hemodynamic characteristics such as blood velocity,blood pressure,flow impingement,wall shear stress and oscillatory shear index are considered to play important roles in the initiation,growth,rupture and recurrence of the cerebral aneurysms.Endovascular therapy is widely implemented to treat the cerebral aneurysms by releasing coils into the aneurysm sac for limiting the blood flow to the sac and stent-assisted coil embolization is adopted to occlude the wide-necked or complex aneurysms.Some researchers believe that stents are not only a mechanical device but may act as a biological system and contribute to vessel wall healing.Hemodynamics simulation helps people understand the effect of hemodynamic characteristics on the recurrence of the coiled aneurysm and it also benefits the interventional planning of neurosurgeons.This study constructed the numerical model for a subject-specific ICA aneurysm treated with stent-assisted coil embolization,which combined the coiled model of the aneurysm with a porous stent placement,and simulated the pulsatile blood flow in these aneurysm models.When a stent was placed across the aneurysm orifice in the coiled aneurysm,the high wall shear stress around the distal aneurysm root was reduced more than that of the coiled aneurysm without a stent.The simulated results point to the conclusion that the stent not only protects the parent artery from occlusion due to extension of coils or thrombosis,but may also reduce the recurrence risk of the stent-assisted coiled aneurysm.展开更多
目的:探究支架辅助弹簧圈栓塞治疗基底动脉顶端动脉瘤(basilar tip aneurysms,BTA)的临床效果及对预后情况的影响。方法:回顾性选取2019年4月—2023年4月南通大学附属如皋医院收治的88例BTA患者。根据手术方案的不同将其分为A组(n=44)与...目的:探究支架辅助弹簧圈栓塞治疗基底动脉顶端动脉瘤(basilar tip aneurysms,BTA)的临床效果及对预后情况的影响。方法:回顾性选取2019年4月—2023年4月南通大学附属如皋医院收治的88例BTA患者。根据手术方案的不同将其分为A组(n=44)与B组(n=44)。A组给予弹簧圈栓塞治疗,B组给予支架辅助弹簧圈栓塞治疗。比较两组栓塞效果,入院时、出院时、出院后6个月预后情况,术前1 d及术后6个月生活质量,并发症。结果:B组动脉瘤总闭塞率为95.45%,高于A组的79.55%,差异有统计学意义(P<0.05)。出院后6个月,B组格拉斯哥预后评分(Glasgow outcome scale,GOS)评分高于A组,改良Rankin量表(modified Rankin scale,mRS)评分低于A组,差异有统计学意义(P<0.05)。术后6个月,B组活力、身体疼痛、生理功能、健康评分均高于A组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:支架辅助弹簧圈栓塞治疗BTA,效果更佳,可改善预后,提高生活质量,安全性良好,应结合瘤体情况科学选择术式。展开更多
基金supported by the National Natural Science Foundation of China (Grant Nos. 30772234 and 30870707)
文摘Hemodynamic characteristics such as blood velocity,blood pressure,flow impingement,wall shear stress and oscillatory shear index are considered to play important roles in the initiation,growth,rupture and recurrence of the cerebral aneurysms.Endovascular therapy is widely implemented to treat the cerebral aneurysms by releasing coils into the aneurysm sac for limiting the blood flow to the sac and stent-assisted coil embolization is adopted to occlude the wide-necked or complex aneurysms.Some researchers believe that stents are not only a mechanical device but may act as a biological system and contribute to vessel wall healing.Hemodynamics simulation helps people understand the effect of hemodynamic characteristics on the recurrence of the coiled aneurysm and it also benefits the interventional planning of neurosurgeons.This study constructed the numerical model for a subject-specific ICA aneurysm treated with stent-assisted coil embolization,which combined the coiled model of the aneurysm with a porous stent placement,and simulated the pulsatile blood flow in these aneurysm models.When a stent was placed across the aneurysm orifice in the coiled aneurysm,the high wall shear stress around the distal aneurysm root was reduced more than that of the coiled aneurysm without a stent.The simulated results point to the conclusion that the stent not only protects the parent artery from occlusion due to extension of coils or thrombosis,but may also reduce the recurrence risk of the stent-assisted coiled aneurysm.
