Abstract
BackgroundIn this study, we develop reliable and practical virtual coiling and stenting methods for intracranial aneurysm surgical planning. Since the purpose of deploying coils and stents is to provide device geometries for subsequent accurate post-treatment computational fluid dynamics analysis, we do not need to accurately capture all the details such as the stress and force distribution for the devices and vessel walls. Our philosophy for developing these methods is to balance accuracy and practicality.MethodsWe consider the mechanical properties of the devices and recapitulate the clinical practice using a finite element method (FEM) approach. At the same time, we apply some simplifications for FEM modeling to make our methods efficient. For the virtual coiling, the coils are modeled as 3D Euler–Bernoulli beam elements, which is computationally efficient and provides good geometry representation. During the stent deployment process, the stent–catheter system is transformed according to the centerline of the parent vessel since the final configuration of the stent is not dependent of the deployment history. The aneurysm and vessel walls are assumed to be rigid and are fully constrained during the simulation. All stent–catheter system and coil–catheter system are prepared and packaged as a library which contains all types of stents, coils and catheters, which improves the efficiency of surgical planning process.ResultsThe stent was delivered to the suitable position during the clinical treatment, achieving good expansion and apposition of the stent to the arterial wall. The coil was deployed into the aneurysm sac and deformed to different shapes because of the stored strain energy during coil package process and the direction of the microcatheter.ConclusionsThe method which we develop here could become surgical planning for intracranial aneurysm treatment in the clinical workflow.
Highlights
In this study, we develop reliable and practical virtual coiling and stenting methods for intracranial aneurysm surgical planning
Library for packaged coils and crimped stents The library for packaged coils and crimpled stents are shown in Fig. 3a, b, which can be transformed to the position for the deployment
The packaged coils and crimped stents can be prepared at the beginning of the simulation which can be very efficient for the virtual treatment
Summary
We develop reliable and practical virtual coiling and stenting methods for intracranial aneurysm surgical planning. Leng et al J Transl Med (2018) 16:208 high-porosity neuro-stent is deployed across the aneurysm to reduce coil herniation [5]. The major drawback for endovascular treatment remains high recanalization (recurrence) rates (30%) [10,11,12] and the need for retreatment in coiled IAs [4]. Patients experiencing these negative outcomes are subjected to increased risk of IA rupture and complications from retreatment and generally have fewer treatment options available. There is no way for clinicians to predict outcome of coiling intervention [9]
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