Computational fluid dynamic analysis following recurrence of cerebral aneurysm after coil embolization

• Published in: Asian journal of neurosurgery Vol. 7; no. 3; pp. 109 - 115
• Main Authors: Irie, Keiko, Anzai, Hitomi, Kojima, Masahiko, Honjo, Naomi, Ohta, Makoto, Hirose, Yuichi, Negoro, Makoto
• Format: Journal Article
• Language: English
• Published: A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Thieme Medical and Scientific Publishers Pvt. Ltd 01.07.2012; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd
• Subjects: Case studies; Diagnosis; Editor's Choice; EDITORS CHOICE; Intracranial aneurysms; Magnetic resonance angiography; Risk factors; Japan; Cerebral aneurysm; endovascular treatment; hemodynamics recanalization; wall shear stress
• ISSN: 1793-5482; 2248-9614
• DOI: 10.4103/1793-5482.103706

Hemodynamic factors are thought to play important role in the initiation, growth, and rupture of cerebral aneurysms. However, hemodynamic features in the residual neck of incompletely occluded aneurysms and their influences on recanalization are rarely reported. This study characterized the hemodynamics of incompletely occluded aneurysms that had been confirmed to undergo recanalization during long-term follow-up using computational fluid dynamic analysis. A ruptured left basilar-SCA aneurysm was incompletely occluded and showed recanalization during 11 years follow-up period. We retrospectively characterized on three-dimensional MR angiography. After subtotal occlusion, the flow pattern, wall shear stress (WSS), and velocity at the remnant neck changed during long-term follow-up period. Specifically, high WSS region and high blood flow velocity were found near the neck. Interestingly, these area of the remnant neck coincided with the location of aneurysm recanalization. High WSS and blood flow velocity were consistently observed near the remnant neck of incompletely occluded aneurysm, prone to future recanalization. It will suggest that hemodynamic factors may play important roles in aneurismal recurrence after endovascular treatment.