Blood Flow Into Basilar Tip Aneurysms: A Predictor for Recanalization After Coil Embolization

Area of Science:

• Neurosurgery
• Interventional Radiology
• Biomedical Engineering

Background:

• Hemodynamic forces are implicated in the recanalization of coiled aneurysms.
• Understanding presurgical hemodynamics is crucial for predicting treatment outcomes.

Purpose of the Study:

• To investigate the influence of presurgical hemodynamics on the efficacy of coil embolization for basilar tip aneurysms.
• To identify hemodynamic predictors of recanalization in coiled basilar tip aneurysms.

Main Methods:

• Computational fluid dynamics (CFD) analysis of 3D rotational angiography data from 57 patients with basilar tip aneurysms.
• Quantification of aneurysmal inflow rate, basilar artery flow rate, and their proportion.
• Assessment of the correlation between basilar bifurcation configuration and hemodynamics.

Main Results:

• Angiographic recanalization was observed in 33.3% of patients.
• The proportion of aneurysmal inflow rate to basilar artery flow rate and coil packing density <30% were independent predictors of recanalization.
• A smaller basilar artery-posterior cerebral artery branch angle was associated with increased blood flow into the aneurysm.

Conclusions:

• The proportion of aneurysmal inflow rate to basilar artery flow rate is a significant predictor of recanalization after coil embolization of basilar tip aneurysms.
• Basilar bifurcation anatomy influences hemodynamics and, consequently, aneurysm recanalization risk.