A new combined parameter predicts re-treatment for coil-embolized aneurysms: a computational fluid dynamics...

Area of Science:

• Neurosurgery
• Medical Imaging
• Biomedical Engineering

Background:

• Coil embolization is a minimally invasive treatment for cerebral aneurysms.
• Recanalization leading to re-treatment remains a significant challenge.
• Predictive tools are needed to identify aneurysms at risk for re-treatment.

Purpose of the Study:

• To identify a combined parameter for predicting aneurysmal re-treatment.
• To analyze hemodynamic, morphological, and clinical factors influencing re-treatment.
• To develop a re-treatment predictor (RP) for cerebral aneurysms.

Main Methods:

• Retrospective analysis of patient-specific geometries for 100 aneurysms (26 re-treated, 74 non-retreated).
• Computation fluid dynamics used to analyze blood flow pre- and post-embolization.
• Multivariable and logistic regression analyses performed to determine the RP.

Main Results:

• Key factors for re-treatment include reduced blood flow velocity rate, increased pressure rate at the neck, and hypertension.
• Pre-embolization hemodynamics were similar between groups.
• Significant post-embolization differences observed in average velocity and its reduction rate in the aneurysmal dome.

Conclusions:

• The developed re-treatment predictor (RP) accurately forecasts aneurysm re-treatment.
• RP integrates hemodynamic, morphological, and clinical data.
• Pre-embolization calculation of RP can guide treatment decisions and identify high-risk aneurysms.