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前交通动脉动脉瘤支架治疗后血管形态及流体力学数值的模拟研究
  • ISSN号:1672-5921
  • 期刊名称:Chinese Journal of Cerebrovascular Diseases
  • 时间:0
  • 页码:148-151
  • 分类:R739.41[医药卫生—肿瘤;医药卫生—临床医学]
  • 作者机构:[1]第二军医大学附属长海医院神经外科,上海200433, [2]复旦大学力学与工程科学系, [3]澳大利亚悉尼麦考瑞大学先进医学研究学院
  • 相关基金:国家自然科学基金(30901556).上海市科委重点项目(08JCl406400)
  • 相关项目:血管内支架网格参数影响脑动脉瘤治疗的血流动力学研究
中文摘要:

目的探讨支架置入治疗前交通动脉宽颈动脉瘤对动脉瘤转归的影响。方法对1例应用支架辅助栓塞前交通动脉宽颈动脉瘤的患者,通过计算流体力学(CFD)有限元方法软件,重建三维血管模型。于支架置入前,截取动脉瘤并修补瘤颈部对应的血管壁,模拟单纯弹簧圈致密栓塞的结果。对比支架置入前后的血管形态改变,分析不同血管形态下的血流动力学参数,包括血液流线、压力及壁面切应力(WSS)等。结果①与单纯弹簧圈致密栓塞对比,支架置入后,血管形态发生明显改变,同侧大脑前动脉A1段和A2段血管夹角增加14.4。;②支架置入后,瘤颈部所对应的血管段内,血液涡流明显减少,流线趋于平直;③单纯弹簧圈致密填塞后瘤颈部平均WSS为11.55Pa,支架置入后,该血管壁平均WSS为7.93Pa,下降31.3%。结论支架置入治疗前交通动脉宽颈动脉瘤可明显改变载瘤动脉的形态,并改变局部载瘤动脉的血流动力学,降低动脉瘤的WSS。

英文摘要:

Objective To investigate the outcome of wide-necked anterior communicating artery aneurysm treated with stent placement. Methods One patient with wide-necked anterior communicating artery aneurysm was treated with stent-assisted coil embolization. The three-dimensional blood vessels model was reconstructed by the software of computational fluid dynamics (CFD) finite element method. Before stent placement, the aneurysm was resected and the corresponding vessel wall at the aneurysm neck was repaired to simulate and the results of dense embolization by coils. The changes of vascular morphology before and after the stent placement were compared. The hemodynamic parameters under the different vascular morphologies were analyzed, including blood flow line, pressure, and wall shear stress (WSS) and so on. Results (1)The vascular morphology changed obviously after stent placement as compared to the dense packing with the simple coils,. The vessel angles of ipsilateral anterior cerebral artery A1 and A2 segments increased 14.4 degrees. (2)After stent placement, the blood eddy current reduced significantly at the corresponding vascular segment of the aneurysm neck, and the blood flow line tended to be straight. (3)After dense packing with the simple coils, the mean WSS at the aneurysm neck was 11.5SPa; after stent placement, the mean WSS of the blood vessel wall was 7.93Pa (decreased 31.3% ). Conclusion The wide-necked anterior communicating artery aneurysm treated with stent placement may significantly change the vascular morphology of parent artery and change the local hemodynamics of parent artery, and reduce the WSS of aneurysm.

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期刊信息
  • 《中国脑血管病杂志》
  • 中国科技核心期刊
  • 主管单位:中华人民共和国计划生育委员会
  • 主办单位:中国医师协会 首都医科大学宣武医院
  • 主编:刘承基 凌锋
  • 地址:北京市长椿街45号
  • 邮编:100053
  • 邮箱:cjcvd@vip.163.com
  • 电话:010-83128791
  • 国际标准刊号:ISSN:1672-5921
  • 国内统一刊号:ISSN:11-5126/R
  • 邮发代号:80-155
  • 获奖情况:
  • 国内外数据库收录:
  • 俄罗斯文摘杂志,美国化学文摘(网络版),荷兰文摘与引文数据库,荷兰医学文摘,中国中国科技核心期刊,中国北大核心期刊(2014版)
  • 被引量:8160