Clinical Significance of Conversion From Computational Fluid Dynamics to Morphology for Risk Evaluation of Aneurysm Recurrence After Coiling. (1st September 2019)

• Record Type: Journal Article
• Authors: Misaki, Kouichi; Nambu, Iku; Uno, Takehiro; Yoshikawa, Akifumi; Uchiyama, Naoyuki; Nakada, Mitsutoshi
• Is Part Of: Neurosurgery. Volume 66(2010)Supplement 1
• Publication Date: 2019-09-01
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz310_503
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Hemodynamic factors play a critical role in the recurrence of intracranial aneurysms after coiling. However, the computational fluid dynamics (CFD) analyses are not consistently performed all over the world, and its benefits were limited in the specific institutes. We tried to convert the hemodynamic parameters to morphological factors for the risk evaluation of aneurysm recurrence after coiling. METHODS: Using pretreatment 3-dimensional rotational angiography data of 50 internal carotid artery aneurysms (7 recanalized, 43 stable) treated with endovascular coiling, we created a virtual post-coiling model produced by cutting the aneurysm dome for construction of virtual coil plane. At the virtual coil plane, we evaluated the pressure difference, which was defined as the pressure elevation at the coil plane from the parent artery divided by the dynamic pressure at the parent artery. After a statistical analysis of the relationship between the pressure difference and aneurysm recurrence, we performed statistical comparisons of pressure difference with morphological factors. RESULTS: Recanalized aneurysms showed a significantly higher pressure difference than stable aneurysms ( P < .001). The receiver operating characteristic analysis showed that the area under the curve value for the pressure difference (0.967). Morphologically, all 5 aneurysms that had the virtual coil plane at the line of upper border of internal carotid artery had a significantly higher pressure difference ( P < .001) and recurred after coiling ( P < .001). CONCLUSION: The pressure difference in the virtual post-coiling model had a strong association with aneurysm recurrence after coiling. Additionally, the location of the coil plane as a morphological factor was significantly associated with pressure difference and aneurysm recurrence. The conversion of hemodynamic factors into simple morphological factors may contribute to expanded applications of the CFD analysis.