How do Coil Configuration and Packing Density Influence Intra-aneurysmal Hemodynamics?

H. MORALES; M. KIM; E. E. VIVAS; M.C. VILLA-URIOL; I. LARRABIDE; T. SOLA; L. GUIMARAENS; A. F. FRANGI

AMERICAN JOURNAL OF NEURORADIOLOGY

AMER SOC NEURORADIOLOGY

Lugar: New York; Año: 2011 vol. 32 p. 1935 - 1941

0195-6108

BACKGROUND AND PURPOSE: Endovascular coiling is a well-established therapy for treating intracranial aneurysms. Nonetheless, postoperatory hemodynamic changes induced by this therapy remain not fully understood. The purpose of this work is to assess the influence of coil configuration and packing attenuation on intra-aneurysmal hemodynamics.MATERIALS AND METHODS: Three 3D rotational angiography images of 3 intracranial aneurysms before and after endovascular coiling were used. For each aneurysm, a 3D representation of the vasculature was obtained after the segmentation of the images. Afterward, a virtual coiling technique was used to treat the aneurysm geometries with coil models. The aneurysms were coiled with 5 packing densities, and each of them was generated by using 3 coil configurations. Computational fluid dynamics analyses were carried out in both untreated and treated aneurysm geometries. Statistical tests were performed to evaluate the relative effect of coil configuration on local hemodynamics.RESULTS: The intra-aneurysmal blood flow velocity and wall shear stress were diminished as packing attenuation increased. Aneurysmal flow velocity was reduced >50% due to the first inserted coils (packing attenuation .01) were found on the hemodynamics due to coil configuration for high packing densities (near 30%). A damping effect was observed on the intra-aneurysmal blood flow waveform after coiling. CONCLUSIONS: Intra-aneurysmal hemodynamics is altered by coils. Coil configuration might reduce its influence on intra-aneurysmal hemodynamics as the packing attenuation increases until an insignificant influence could be achieved for high packing densities.