Risk Factors for Recanalization after Coil Embolization.

Area of Science:

• Neuroendovascular procedures
• Cerebrovascular diseases
• Medical imaging and simulation

Background:

• Coil embolization is a common treatment for cerebral aneurysms.
• Recanalization remains a significant challenge, impacting long-term treatment efficacy.
• Identifying predictors of recanalization is crucial for improving patient outcomes.

Purpose of the Study:

• To identify clinical and morphological risk factors for recanalization 6 months post-coil embolization.
• To utilize computational fluid dynamics (CFD) to validate identified risk factors.
• To establish complex flow patterns as potential predictors of recanalization.

Main Methods:

• Retrospective analysis of clinical data from 184 patients.
• Generation of aneurysm models based on ROC curve analysis for risk stratification.
• Application of CFD to analyze hemodynamics in high-risk and low-risk aneurysm models.

Main Results:

• Aneurysm filling and neck size were independent risk factors for recanalization.
• Packing density was a protective factor for recanalization in both subarachnoid hemorrhage (SAH) and unruptured aneurysm cohorts.
• Complex flow patterns and multiple vortices, associated with aneurysm shape, characterized high recanalization risk.

Conclusions:

• Recanalization risk is multifactorial, influenced by clinical and morphological parameters.
• Exceeding specific morphometric thresholds leads to complex intra-aneurysmal flow.
• CFD analysis confirmed complex flow patterns as a relevant predictor of recanalization, validating statistical findings.