title: Computational simulation of therapeutic parent artery occlusion to treat giant vertebrobasilar aneurysm.
abstract: We applied computational fluid dynamics (CFD) analysis to assess 3D digital subtraction angiography findings in a patient with a giant vertebrobasilar aneurysm to simulate and compare the consequences of left and right vertebral artery occlusion. The balloon occlusion test suggested that occlusion of the right vertebral artery is the better way to treat this patient's aneurysm from the point of view of aneurysmal thrombosis and isolation from the circulation. The computer simulation supported this conclusion, at the same time indicating that from the point of view of pressure distribution on the wall of the aneurysm, the right vertebral occlusion may be also accompanied by an undesirable effect. A high-pressure area on the aneurysm wall in systole was revealed. This high pressure potentially could lead to subsequent aneurysmal growth, which indeed occurred, as was revealed by a follow-up examination 6 months later. This study is a good example of possible future applications of CFD in patients with cerebrovascular disease before therapeutic intervention.
authors.affiliation: Department of Neuroendovascular Therapy, Tohoku University Graduate School of Medicine, Shock Wave Research Center, Sendai, Japan.
authors.forename: Tamer
authors.initials: T
authors.lastname: Hassan
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ezura
authors.forename: Eugene V
authors.initials: EV
authors.lastname: Timofeev
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saito
authors.forename: Akira
authors.initials: A
authors.lastname: Takahashi
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Takayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshimoto
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D021721:Balloon Occlusion; D004621:Embolization, Therapeutic; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*