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Tytuł:
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Blood flow stagnation after treatment of a giant internal carotid artery aneurysm: a computed fluid dynamics analysis.
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Autorzy:
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Muraoka S; Department of Neurosurgery, Kariya Toyota General Hospital, Sumiyoshi Cho 5-15, Kariya, Aichi, Japan. .
Takagi R; Department of Mechanical Engineering, Nagoya Institute of Technology, Gokiso Cho, Showa-ku, Nagoya, Aichi, Japan.
Araki Y; Department of Neurosurgery, Nagoya University Graduate School of Medicine, Tsurumai Cho 65, Showa-ku, Nagoya, Aichi, Japan.
Uda K; Department of Neurosurgery, Nagoya University Graduate School of Medicine, Tsurumai Cho 65, Showa-ku, Nagoya, Aichi, Japan.
Sumitomo M; Department of Neurosurgery, Toyota Kosei Hospital, Ibobara 500-1, Josui Cho, Toyota, Aichi, Japan.
Okamoto S; Department of Neurosurgery, Aichi Rehabilitation Hospital, Nishigara 1-1, Ebara Cho, Nishio, Aichi, Japan.
Nishihori M; Department of Neurosurgery, Nagoya University Graduate School of Medicine, Tsurumai Cho 65, Showa-ku, Nagoya, Aichi, Japan.
Izumi T; Department of Neurosurgery, Nagoya University Graduate School of Medicine, Tsurumai Cho 65, Showa-ku, Nagoya, Aichi, Japan.
Nakamura M; Department of Mechanical Engineering, Nagoya Institute of Technology, Gokiso Cho, Showa-ku, Nagoya, Aichi, Japan.
Saito R; Department of Neurosurgery, Nagoya University Graduate School of Medicine, Tsurumai Cho 65, Showa-ku, Nagoya, Aichi, Japan.
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Źródło:
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Scientific reports [Sci Rep] 2022 May 04; Vol. 12 (1), pp. 7283. Date of Electronic Publication: 2022 May 04.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : Nature Publishing Group, copyright 2011-
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MeSH Terms:
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Carotid Artery Diseases*/complications
Carotid Artery Diseases*/diagnostic imaging
Carotid Artery Diseases*/surgery
Cerebral Revascularization*/adverse effects
Cerebral Revascularization*/methods
Intracranial Aneurysm*/complications
Intracranial Aneurysm*/diagnostic imaging
Intracranial Aneurysm*/surgery
Carotid Artery, Internal/diagnostic imaging ; Carotid Artery, Internal/surgery ; Humans ; Hydrodynamics ; Postoperative Complications/etiology
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References:
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Entry Date(s):
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Date Created: 20220504 Date Completed: 20220506 Latest Revision: 20220615
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Update Code:
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20240104
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PubMed Central ID:
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PMC9068907
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DOI:
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10.1038/s41598-022-11321-6
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PMID:
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35508591
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Balloon test occlusion (BTO) is an angiographic test to evaluate ischemic tolerance after permanent occlusion of an internal carotid artery (ICA). BTO can simulate ischemia caused by parent artery occlusion and can be used to select a suitable bypass surgery using specific criteria. On the other hand, a postoperative thrombus can form despite proper case selection, optimal radiological evaluation, and an appropriate surgical strategy. Postoperative ischemic complications related to perforating branches are clinically significant. This simulation study aimed to analyze postoperative flow characteristics and elucidate the cause of ischemic complications related to the perforating branch using computational fluid dynamics (CFD). An unexpected postoperative thrombus formation related to the perforating branch occurred after treating a giant aneurysm in the cavernous portion of the ICA in a patient. Three-dimensional digital subtraction angiography was used to acquire flow data and set up the CFD simulation. The flow simulations were performed at various bypass flow rates. The CFD analysis indicated flow stagnation in the ICA only when surgical treatment using a low-flow bypass graft was performed. Thrombus formation may lead to ischemic complications related to the perforating branch, such as the anterior choroidal artery. BTO did not reflect the influence of bypass blood flow. Therefore, recognizing that blood flow stagnation may occur and comprehensively deciding on the surgical strategy by CFD analysis can be helpful to prevent ischemic complications in patients with giant aneurysms.
(© 2022. The Author(s).)
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