TY - JOUR
T1 - Blood Flow into Basilar Tip Aneurysms
T2 - A Predictor for Recanalization after Coil Embolization
AU - Sugiyama, Shin Ichiro
AU - Niizuma, Kuniyasu
AU - Sato, Kenichi
AU - Rashad, Sherif
AU - Kohama, Misaki
AU - Endo, Hidenori
AU - Endo, Toshiki
AU - Matsumoto, Yasushi
AU - Ohta, Makoto
AU - Tominaga, Teiji
N1 - Publisher Copyright:
© 2016 American Heart Association, Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background and Purpose - Hemodynamic forces may play a role in the recanalization of coiled aneurysms. The purpose of this study was to investigate the influence of presurgical hemodynamics on the efficacy of coil embolization for basilar tip aneurysms. Methods - We identified 82 patients who underwent endovascular coil embolization for basilar tip aneurysms with a follow-up of >1 year. Presurgical hemodynamics were investigated using computational fluid dynamics with 3-dimensional data derived from rotational angiography. During postprocessing, we quantified the rate of net flow entering the aneurysm through its neck and calculated the proportion of the aneurysmal inflow rate to the basilar artery flow rate. In addition, we investigated the correlation between the basilar bifurcation configuration and the hemodynamics. Results - Twenty-five of the 82 patients were excluded because of difficult vascular geometry reconstruction. Among the 57 examined patients, angiographic recanalization was observed in 19 patients (33.3%). The proportion of the aneurysmal inflow rate to the basilar artery flow rate and a coil packing density <30% were independent and significant predictors for the recanalization of coiled aneurysms. Additional investigation revealed that a small branch angle formed by the basilar artery and the posterior cerebral artery increased blood flow into the aneurysm. Conclusions - The proportion of the aneurysmal inflow rate to the basilar artery flow rate, influenced by the basilar bifurcation configuration, was an independent and significant predictor for recanalization after coil embolization in basilar tip aneurysms.
AB - Background and Purpose - Hemodynamic forces may play a role in the recanalization of coiled aneurysms. The purpose of this study was to investigate the influence of presurgical hemodynamics on the efficacy of coil embolization for basilar tip aneurysms. Methods - We identified 82 patients who underwent endovascular coil embolization for basilar tip aneurysms with a follow-up of >1 year. Presurgical hemodynamics were investigated using computational fluid dynamics with 3-dimensional data derived from rotational angiography. During postprocessing, we quantified the rate of net flow entering the aneurysm through its neck and calculated the proportion of the aneurysmal inflow rate to the basilar artery flow rate. In addition, we investigated the correlation between the basilar bifurcation configuration and the hemodynamics. Results - Twenty-five of the 82 patients were excluded because of difficult vascular geometry reconstruction. Among the 57 examined patients, angiographic recanalization was observed in 19 patients (33.3%). The proportion of the aneurysmal inflow rate to the basilar artery flow rate and a coil packing density <30% were independent and significant predictors for the recanalization of coiled aneurysms. Additional investigation revealed that a small branch angle formed by the basilar artery and the posterior cerebral artery increased blood flow into the aneurysm. Conclusions - The proportion of the aneurysmal inflow rate to the basilar artery flow rate, influenced by the basilar bifurcation configuration, was an independent and significant predictor for recanalization after coil embolization in basilar tip aneurysms.
KW - hemodynamics
KW - intracranial aneurysm
KW - recurrence
KW - rest
KW - risk factor
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U2 - 10.1161/STROKEAHA.116.013555
DO - 10.1161/STROKEAHA.116.013555
M3 - Article
C2 - 27625377
AN - SCOPUS:84987621348
VL - 47
SP - 2541
EP - 2547
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 10
ER -