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

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: Circled digit oneThe 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. Circled digit twoAfter 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. Circled digit threeAfter dense packing with the simple coils, the mean WSS at the aneurysm neck was 11.55Pa; 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.