Abstract
PurposeA previous study on computational fluid dynamics reported that a high pressure difference (PD) at the surface of a coil mass is a strong predictor of aneurysm recurrence after coil embolization. PD was calculated using a virtual post-coiling model (VM), created by manually cutting the aneurysm by the flat plane from an anatomic model created with pre-coil embolization data; however, its credibility has not been fully evaluated. This study aims to clarify whether PD values calculated using the post-coiling model, which reflects the actual coil plane, are a strong predictor of aneurysm recurrence.MethodsFifty internal carotid artery aneurysms treated with endovascular coil embolization were analyzed (7 recanalized, 43 stable). We created and subjected two post-coiling models, namely, VM and the real post-coiling model (RM), constructed from the post-coil embolization data. The relationship between PD and aneurysm recurrence was examined using these models. PD and its constituent three parameters were compared between VM and RM.ResultsPD values calculated using RM showed significantly higher aneurysm recurrence in recurrence group than stable group (p < 0.001), and multivariate analysis showed that PD in RM (p = 0.02; odds ratio, 36.24) was significantly associated with aneurysm recurrence. The receiver operating characteristic analysis revealed that PD values accurately predicted aneurysm recurrence (area under the curve, 0.977; cutoff value, 3.08; sensitivity, 100%; specificity, 97.7%). All four parameters showed a significant correlation with VM and RM (p < 0.001).ConclusionUse of PD to predict recurrence after coil embolization can be clinically relevant.
Highlights
Endovascular coil embolization is a safe and reliable technique for intracranial aneurysm treatment [1, 2]
We investigated the role of pressure difference (PD) in predicting aneurysm recurrence after coil embolization using virtual post-coiling model (VM) and real postcoiling model (RM), and we compared the results of both models
No significant differences were found in terms of the three components of PD; PD was significantly higher in the recanalized aneurysm group than in the stable aneurysm group
Summary
Endovascular coil embolization is a safe and reliable technique for intracranial aneurysm treatment [1, 2]. Nambu et al [9] thoroughly investigated the risk factors for aneurysm recurrence after coil embolization by conducting CFD analysis using the virtual post-coiling model (VM). VM was constructed from the pre-coil embolization data and by manually cutting the aneurysm by the flat plane, dividing the aneurysm dome and the origin of the branching vessel or parent artery. They concluded that a high pressure difference (PD) was the strongest predictor for aneurysm recurrence when compared with other morphological and hemodynamic parameters. We investigated the role of PD in predicting aneurysm recurrence after coil embolization using VM and RM, and we compared the results of both models
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