title: Hemodynamic alterations after stent implantation in 15 cases of intracranial aneurysm.
abstract: BACKGROUND
  Stent-assisted coiling technology has been widely used in the treatment of intracranial aneurysms. In the current study, we investigated the intra-aneurysmal hemodynamic alterations after stent implantation and their association with the aneurysm location.
  
  
  METHODS
  We first retrospectively studied 15 aneurysm cases [8 internal carotid artery-ophthalmic artery (ICA-OphA) aneurysms and 7 posterior communicating artery (PcoA) aneurysms] treated with Enterprise stents and coils. Then, based on the patient-specific geometries before and after stenting, we built virtual stenting computational fluid dynamics (CFD) simulation models.
  
  
  RESULTS
  Before and after the stent deployment, the average wall shear stress (WSS) on the aneurysmal sac at systolic peak changed from 7.04 Pa (4.14 Pa, 15.77 Pa) to 6.04 Pa (3.86 Pa, 11.13 Pa), P = 0.001; the spatially averaged flow velocity in the perpendicular plane of the aneurysm dropped from 0.5 m/s (0.28 m/s, 0.7 m/s) to 0.33 m/s (0.25 m/s, 0.49 m/s), P = 0.001, respectively. Post stent implantation, the WSS in ICA-OphA aneurysms and PcoA aneurysms decreased by 14.4 % (P = 0.012) and 16.6 % (P = 0.018), respectively, and the flow velocity also reduced by 10.3 % (P = 0.029) and 10.5 % (P = 0.013), respectively. Changes in the WSS, flow velocity, and pressure were not significantly different between ICA-OphA and PcoA aneurysms (P > 0.05). Stent implantation did not significantly change the peak systolic pressure in either aneurysm type.
  
  
  CONCLUSIONS
  After the stent implantation, both the intra-aneurysmal flow velocity and WSS decreased independently of aneurysm type (ICA-OphA and PcoA). Little change was observed in peak systolic pressure.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, China, 100050.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, China, 100050.
authors.forename: Zhongbin
authors.initials: Z
authors.lastname: Tian
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, China, 100050.
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, China, 100050.
authors.forename: Linkai
authors.initials: L
authors.lastname: Jing
authors.affiliation: Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Paliwal
authors.affiliation: Department of Mechanics and Engineering Science, Fudan University, Shanghai, China.
authors.forename: Shengzhang
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, China, 100050.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Jianping
authors.initials: J
authors.lastname: Xiang
authors.affiliation: Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Radiology, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
authors.affiliation: Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Meng
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, China, 100050. yang-xj@163.net.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015607:Stents; D013314:Stress, Mechanical; D016896:Treatment Outcome
keywords: Hemodynamics; Intracranial aneurysm; Pressure; Stent; Velocity; Wall shear stress