动脉瘤
血流动力学
医学
闭塞
流出
流入
心脏病学
内科学
流速
血流
数字减影血管造影
放射科
核医学
血管造影
地质学
物理
机械
放松(心理学)
海洋学
作者
Philipp Gölitz,Hannes Luecking,Philip Hoelter,Frauke Knossalla,Arnd Doerfler
出处
期刊:Neuroradiology
[Springer Nature]
日期:2020-03-13
卷期号:62 (8): 1043-1050
被引量:10
标识
DOI:10.1007/s00234-020-02390-3
摘要
Abstract Purpose Using the Woven EndoBridge (WEB) for aneurysm treatment has emerged as endovascular approach aiming for flow disruption in aneurysm sac. Since quantifiable data confirming the hemodynamic effect are lacking, we investigated in vivo aneurysmal flow alterations using time-density curve (TDC) analysis. Additionally, we evaluated whether flow parameters could be identified as independent factor to predict aneurysm occlusion. Methods Forty cerebral aneurysm patients treated with WEB were enrolled. Pre- and postinterventional digital subtraction angiography series were postprocessed and TDCs generated. TDCs were quantified calculating the parameters aneurysmal inflow velocity, outflow velocity, mean flow velocity, and relative time-to-peak (rTTP) of aneurysm filling. Pre- and postinterventional values were compared and related to occlusion rate. Results WEB implanting induced highly significant rTTP prolongation by 52% ( p = 0.001) and highly significant decrease of aneurysmal inflow, outflow, and mean flow velocity ( p < 0.001). While outflow velocity was reduced by 49%, inflow velocity was reduced by 33% only. No statistically significant difference between the occluded and the non-occluded group was observed. No flow parameter reached significance level concerning predicting aneurysm occlusion. Conclusion Flow quantification confirms a significant flow-disrupting effect of WEB reducing more the outflow than the inflow velocity. In our small cohort, no flow parameter reached statistical significance to show predictive value regarding complete aneurysm occlusion. The hemodynamic effect of WEB is on comparable level to flow-diverting stents meaning that aneurysm closure can be delayed. In case of only slight inflow changes and high aneurysmal hemodynamic stress, some aneurysms might not be adequately protected in the short term.
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