How do coil configuration and packing density influence intra-aneurysmal hemodynamics?

Area of Science:

• Biomedical Engineering
• Medical Imaging
• Computational Fluid Dynamics

Background:

• Endovascular coiling is a standard treatment for intracranial aneurysms.
• Postoperative hemodynamic changes require further understanding.

Purpose of the Study:

• To evaluate how coil configuration and packing density impact intra-aneurysmal hemodynamics.
• To analyze changes in blood flow velocity and wall shear stress.

Main Methods:

• Utilized 3D rotational angiography images of three aneurysms.
• Created 3D vascular models and simulated virtual coiling with varying densities and configurations.
• Performed computational fluid dynamics (CFD) analysis on treated and untreated models.

Main Results:

• Increased coil packing density reduced intra-aneurysmal blood flow velocity and wall shear stress.
• Initial coils (packing density <12%) reduced velocity by over 50%, depending on configuration.
• Coil configuration had a non-significant effect on hemodynamics at high packing densities (approx. 30%).
• A damping effect on blood flow waveforms was observed post-coiling.

Conclusions:

• Coil placement significantly alters intra-aneurysmal hemodynamics.
• Higher packing densities minimize the influence of coil configuration on hemodynamics.