Abstract

ObjectiveThis study aims to compare the hemodynamic impact of stent-mesh and stent-induced straightening of the parent artery in intracranial bifurcation aneurysms using finite element method simulation.Material and MethodsThree intracranial bifurcation aneurysms treated with different stent-assisted coil embolization were evaluated. Simulation using the finite element method was conducted for Solitaire, LVIS and Neuroform stents. Four models of each stent were established, including a pre-treatment baseline, stenting without parent artery straightening (presented as stent-mesh effect), no-stent with parent artery reconstruction (to reveal the straightening impact), and stenting with straightening (categorized as Models I–IV respectively). Hemodynamic characteristics of the four models for each stent were compared.ResultsIn the Neuroform stent, compared with the pre-treatment model (100%), the mean WSS decreased to 82.3, 71.4, and 57.0% in Models II-IV, velocity to 88.3, 74.4, and 62.8%, and high flow volume (HFV, >0.3 m/s) to 77.7, 44.0, and 19.1%. For the LVIS stent, the mean WSS changed to 105.0, 40.2, and 39.8% in Models II to IV; velocity to 91.2, 58.1, and 52.5%, and HFV to 92.0, 56.1, and 43.9%. For the Solitaire stent, compared with the pre-treatment model (100%), the mean WSS of Models II-IV changed altered by 105.7, 42.6, and 39.4%, sac-averaged velocity changed to 111.3, 46.6, and 42.8%, and HFV 115.6, 15.1, and 13.6%.ConclusionThe hemodynamic effect of straightening the parent artery of intracranial bifurcation aneurysms by stenting was noticeably improved over stent mesh diversion in all three stents tested. Therefore stent-induced remodeling of the parent artery appears to be the best method of decreasing recurrence in intracranial bifurcation aneurysms.

Highlights

  • Stent-assisted coil embolization can decrease the recurrence rate compared with simple coiling in intracranial aneurysms [1]

  • This study aims to assess and compare the hemodynamic characteristics of stent-meshes and stentinduced straightening of parent artery in intracranial bifurcation aneurysms based on computational simulations using the highfidelity finite element method

  • Three intracranial bifurcation aneurysms treated with three different stent-assisted coil embolization were evaluated

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Summary

Introduction

Stent-assisted coil embolization can decrease the recurrence rate compared with simple coiling in intracranial aneurysms [1]. The stent has a scaffold function and can induce angular deformation of parent arteries in the intracranial bifurcation aneurysms [2–4]. It can migrate the flow impingement away from the aneurysm neck to decrease recurrence [5–7]. The hemodynamic impact of the stent mesh vs stent-induced straightening of the parent artery of the intracranial bifurcation aneurysm is unknown. This study aims to assess and compare the hemodynamic characteristics of stent-meshes and stentinduced straightening of parent artery in intracranial bifurcation aneurysms based on computational simulations using the highfidelity finite element method

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