Hemodynamic Changes Caused by Multiple Stenting in Vertebral Artery Fusiform Aneurysms: A Patient-Specific...

Area of Science:

• Medical Imaging and Simulation
• Biomedical Engineering
• Cardiovascular Research

Background:

• Multiple stent placement improves outcomes for intracranial fusiform aneurysms.
• Hemodynamic mechanisms underlying this technique are not fully understood.

Purpose of the Study:

• To analyze hemodynamic changes from different stent strategies in patient-specific models.
• To provide data supporting clinical decisions for aneurysm treatment.

Main Methods:

• Computational fluid dynamics (CFD) used on 10 patient-specific vertebral artery fusiform aneurysm models.
• Simulated sequential stent placements (1-3 stents) using a virtual stenting technique.
• Compared hemodynamic parameters: wall shear stress, pressure, OSI, RRT, and flow patterns.

Main Results:

• Wall shear stress decreased progressively with more stents (7.2% to 25.8%).
• Relative residence time and pressure increased significantly with stent number.
• Flow patterns improved by reducing vortex intensity and displacement.

Conclusions:

• Stent placement alters hemodynamics in vertebral artery fusiform aneurysms, potentially aiding thrombosis.
• The effect intensifies with increased stent deployment.
• Potential risks of rupture or recanalization necessitate careful planning.