The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents

Autores
Narata, A. P.; De Moura, F. S.; Larrabide, Ignacio; Perrault, C. M.; Patat, F.; Bibi, R.; Velasco, S.; Januel, A. C.; Cognard, C.; Chapot, R.; Bouakaz, A.; Sennoga, C. A.; Marzo, A.
Año de publicación
2018
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
BACKGROUND AND PURPOSE: Treatment of intracranial bifurcation aneurysms with flow-diverter stents can lead to caliber changes of the distal vessels in a subacute phase. This study aims to evaluate whether local anatomy and flow disruption induced by flow-diverter stents are associated with vessel caliber changes in intracranial bifurcations. MATERIALS AND METHODS: Radiologic images and demographic data were acquired for 25 patients with bifurcation aneurysms treated with flow-diverter stents. Whisker plots and Mann-Whitney rank sum tests were used to evaluate if anatomic data and caliber changes could be linked. Symmetry/asymmetry were defined as diameter ratio 1 symmetric and diameter ratio 1 asymmetric. Computational fluid dynamics was performed on idealized and patient-specific anatomies to evaluate flow changes induced by flow-diverter stents in the jailed vessel. RESULTS: Statistical analysis identified a marked correspondence between asymmetric bifurcation and caliber change. Symmetry ratios were lower for cases showing narrowing or subacute occlusion (medium daughter vessel diameter ratio 0.59) compared with cases with posttreatment caliber conservation (medium daughter vessel diameter ratio 0.95). Computational fluid dynamics analysis in idealized and patient-specific anatomies showed that wall shear stress in the jailed vessel was more affected when flow-diverter stents were deployed in asymmetric bifurcations (diameter ratio 0.65) and less affected when deployed in symmetric anatomies (diameter ratio 1.00). CONCLUSIONS: Anatomic data analysis showed statistically significant correspondence between caliber changes and bifurcation asymmetry characterized by diameter ratio 0.7 (P .001). Similarly, computational fluid dynamics results showed the highest impact on hemodynamics when flow-diverter stents are deployed in asymmetric bifurcations (diameter ratio 0.65) with noticeable changes on wall sheer stress fields. Further research and clinical validation are necessary to identify all elements involved in vessel caliber changes after flow-diverter stent procedures.
Fil: Narata, A. P.. Centre Hospitalier Regional Et Universitaire de Tours; Francia
Fil: De Moura, F. S.. Universidade Federal Do Abc; Brasil
Fil: Larrabide, Ignacio. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Exactas. Grupo de Plasmas Densos Magnetizados. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Grupo de Plasmas Densos Magnetizados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil; Argentina
Fil: Perrault, C. M.. University Of Sheffield; Reino Unido
Fil: Patat, F.. Universite de Tours; Francia
Fil: Bibi, R.. Centre Hospitalier Regional Et Universitaire de Tours; Francia
Fil: Velasco, S.. Université de Poitiers; Francia
Fil: Januel, A. C.. Centre Hospitalier Universitaire de Toulouse; Francia
Fil: Cognard, C.. Centre Hospitalier Universitaire de Toulouse; Francia
Fil: Chapot, R.. Alfried Krupp Krankenhaus; Alemania
Fil: Bouakaz, A.. Universite de Tours; Francia
Fil: Sennoga, C. A.. Universite de Tours; Francia
Fil: Marzo, A.. University Of Sheffield; Reino Unido
Materia
Aneurismascerebrales
Tratamiento
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/58078
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/58078
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repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter StentsNarata, A. P.De Moura, F. S.Larrabide, IgnacioPerrault, C. M.Patat, F.Bibi, R.Velasco, S.Januel, A. C.Cognard, C.Chapot, R.Bouakaz, A.Sennoga, C. A.Marzo, A.AneurismascerebralesTratamientohttps://purl.org/becyt/ford/3.4https://purl.org/becyt/ford/3BACKGROUND AND PURPOSE: Treatment of intracranial bifurcation aneurysms with flow-diverter stents can lead to caliber changes of the distal vessels in a subacute phase. This study aims to evaluate whether local anatomy and flow disruption induced by flow-diverter stents are associated with vessel caliber changes in intracranial bifurcations. MATERIALS AND METHODS: Radiologic images and demographic data were acquired for 25 patients with bifurcation aneurysms treated with flow-diverter stents. Whisker plots and Mann-Whitney rank sum tests were used to evaluate if anatomic data and caliber changes could be linked. Symmetry/asymmetry were defined as diameter ratio 1 symmetric and diameter ratio 1 asymmetric. Computational fluid dynamics was performed on idealized and patient-specific anatomies to evaluate flow changes induced by flow-diverter stents in the jailed vessel. RESULTS: Statistical analysis identified a marked correspondence between asymmetric bifurcation and caliber change. Symmetry ratios were lower for cases showing narrowing or subacute occlusion (medium daughter vessel diameter ratio 0.59) compared with cases with posttreatment caliber conservation (medium daughter vessel diameter ratio 0.95). Computational fluid dynamics analysis in idealized and patient-specific anatomies showed that wall shear stress in the jailed vessel was more affected when flow-diverter stents were deployed in asymmetric bifurcations (diameter ratio 0.65) and less affected when deployed in symmetric anatomies (diameter ratio 1.00). CONCLUSIONS: Anatomic data analysis showed statistically significant correspondence between caliber changes and bifurcation asymmetry characterized by diameter ratio 0.7 (P .001). Similarly, computational fluid dynamics results showed the highest impact on hemodynamics when flow-diverter stents are deployed in asymmetric bifurcations (diameter ratio 0.65) with noticeable changes on wall sheer stress fields. Further research and clinical validation are necessary to identify all elements involved in vessel caliber changes after flow-diverter stent procedures.Fil: Narata, A. P.. Centre Hospitalier Regional Et Universitaire de Tours; FranciaFil: De Moura, F. S.. Universidade Federal Do Abc; BrasilFil: Larrabide, Ignacio. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Exactas. Grupo de Plasmas Densos Magnetizados. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Grupo de Plasmas Densos Magnetizados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil; ArgentinaFil: Perrault, C. M.. University Of Sheffield; Reino UnidoFil: Patat, F.. Universite de Tours; FranciaFil: Bibi, R.. Centre Hospitalier Regional Et Universitaire de Tours; FranciaFil: Velasco, S.. Université de Poitiers; FranciaFil: Januel, A. C.. Centre Hospitalier Universitaire de Toulouse; FranciaFil: Cognard, C.. Centre Hospitalier Universitaire de Toulouse; FranciaFil: Chapot, R.. Alfried Krupp Krankenhaus; AlemaniaFil: Bouakaz, A.. Universite de Tours; FranciaFil: Sennoga, C. A.. Universite de Tours; FranciaFil: Marzo, A.. University Of Sheffield; Reino UnidoAmerican Society of Neuroradiology2018-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/58078Narata, A. P.; De Moura, F. S.; Larrabide, Ignacio; Perrault, C. M.; Patat, F.; et al.; The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents; American Society of Neuroradiology; American Journal Of Neuroradiology; 39; 2; 2-2018; 323-3300195-6108CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.3174/ajnr.A5471info:eu-repo/semantics/altIdentifier/url/http://www.ajnr.org/content/39/2/323info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-12-23T14:15:55Zoai:ri.conicet.gov.ar:11336/58078instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-12-23 14:15:56.167CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
title The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
spellingShingle The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
Narata, A. P.
Aneurismascerebrales
Tratamiento
title_short The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
title_full The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
title_fullStr The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
title_full_unstemmed The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
title_sort The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents
dc.creator.none.fl_str_mv Narata, A. P.
De Moura, F. S.
Larrabide, Ignacio
Perrault, C. M.
Patat, F.
Bibi, R.
Velasco, S.
Januel, A. C.
Cognard, C.
Chapot, R.
Bouakaz, A.
Sennoga, C. A.
Marzo, A.
author Narata, A. P.
author_facet Narata, A. P.
De Moura, F. S.
Larrabide, Ignacio
Perrault, C. M.
Patat, F.
Bibi, R.
Velasco, S.
Januel, A. C.
Cognard, C.
Chapot, R.
Bouakaz, A.
Sennoga, C. A.
Marzo, A.
author_role author
author2 De Moura, F. S.
Larrabide, Ignacio
Perrault, C. M.
Patat, F.
Bibi, R.
Velasco, S.
Januel, A. C.
Cognard, C.
Chapot, R.
Bouakaz, A.
Sennoga, C. A.
Marzo, A.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Aneurismascerebrales
Tratamiento
topic Aneurismascerebrales
Tratamiento
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.4
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv BACKGROUND AND PURPOSE: Treatment of intracranial bifurcation aneurysms with flow-diverter stents can lead to caliber changes of the distal vessels in a subacute phase. This study aims to evaluate whether local anatomy and flow disruption induced by flow-diverter stents are associated with vessel caliber changes in intracranial bifurcations. MATERIALS AND METHODS: Radiologic images and demographic data were acquired for 25 patients with bifurcation aneurysms treated with flow-diverter stents. Whisker plots and Mann-Whitney rank sum tests were used to evaluate if anatomic data and caliber changes could be linked. Symmetry/asymmetry were defined as diameter ratio 1 symmetric and diameter ratio 1 asymmetric. Computational fluid dynamics was performed on idealized and patient-specific anatomies to evaluate flow changes induced by flow-diverter stents in the jailed vessel. RESULTS: Statistical analysis identified a marked correspondence between asymmetric bifurcation and caliber change. Symmetry ratios were lower for cases showing narrowing or subacute occlusion (medium daughter vessel diameter ratio 0.59) compared with cases with posttreatment caliber conservation (medium daughter vessel diameter ratio 0.95). Computational fluid dynamics analysis in idealized and patient-specific anatomies showed that wall shear stress in the jailed vessel was more affected when flow-diverter stents were deployed in asymmetric bifurcations (diameter ratio 0.65) and less affected when deployed in symmetric anatomies (diameter ratio 1.00). CONCLUSIONS: Anatomic data analysis showed statistically significant correspondence between caliber changes and bifurcation asymmetry characterized by diameter ratio 0.7 (P .001). Similarly, computational fluid dynamics results showed the highest impact on hemodynamics when flow-diverter stents are deployed in asymmetric bifurcations (diameter ratio 0.65) with noticeable changes on wall sheer stress fields. Further research and clinical validation are necessary to identify all elements involved in vessel caliber changes after flow-diverter stent procedures.
Fil: Narata, A. P.. Centre Hospitalier Regional Et Universitaire de Tours; Francia
Fil: De Moura, F. S.. Universidade Federal Do Abc; Brasil
Fil: Larrabide, Ignacio. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Exactas. Grupo de Plasmas Densos Magnetizados. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Grupo de Plasmas Densos Magnetizados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil; Argentina
Fil: Perrault, C. M.. University Of Sheffield; Reino Unido
Fil: Patat, F.. Universite de Tours; Francia
Fil: Bibi, R.. Centre Hospitalier Regional Et Universitaire de Tours; Francia
Fil: Velasco, S.. Université de Poitiers; Francia
Fil: Januel, A. C.. Centre Hospitalier Universitaire de Toulouse; Francia
Fil: Cognard, C.. Centre Hospitalier Universitaire de Toulouse; Francia
Fil: Chapot, R.. Alfried Krupp Krankenhaus; Alemania
Fil: Bouakaz, A.. Universite de Tours; Francia
Fil: Sennoga, C. A.. Universite de Tours; Francia
Fil: Marzo, A.. University Of Sheffield; Reino Unido
description BACKGROUND AND PURPOSE: Treatment of intracranial bifurcation aneurysms with flow-diverter stents can lead to caliber changes of the distal vessels in a subacute phase. This study aims to evaluate whether local anatomy and flow disruption induced by flow-diverter stents are associated with vessel caliber changes in intracranial bifurcations. MATERIALS AND METHODS: Radiologic images and demographic data were acquired for 25 patients with bifurcation aneurysms treated with flow-diverter stents. Whisker plots and Mann-Whitney rank sum tests were used to evaluate if anatomic data and caliber changes could be linked. Symmetry/asymmetry were defined as diameter ratio 1 symmetric and diameter ratio 1 asymmetric. Computational fluid dynamics was performed on idealized and patient-specific anatomies to evaluate flow changes induced by flow-diverter stents in the jailed vessel. RESULTS: Statistical analysis identified a marked correspondence between asymmetric bifurcation and caliber change. Symmetry ratios were lower for cases showing narrowing or subacute occlusion (medium daughter vessel diameter ratio 0.59) compared with cases with posttreatment caliber conservation (medium daughter vessel diameter ratio 0.95). Computational fluid dynamics analysis in idealized and patient-specific anatomies showed that wall shear stress in the jailed vessel was more affected when flow-diverter stents were deployed in asymmetric bifurcations (diameter ratio 0.65) and less affected when deployed in symmetric anatomies (diameter ratio 1.00). CONCLUSIONS: Anatomic data analysis showed statistically significant correspondence between caliber changes and bifurcation asymmetry characterized by diameter ratio 0.7 (P .001). Similarly, computational fluid dynamics results showed the highest impact on hemodynamics when flow-diverter stents are deployed in asymmetric bifurcations (diameter ratio 0.65) with noticeable changes on wall sheer stress fields. Further research and clinical validation are necessary to identify all elements involved in vessel caliber changes after flow-diverter stent procedures.
publishDate 2018
dc.date.none.fl_str_mv 2018-02
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/58078
Narata, A. P.; De Moura, F. S.; Larrabide, Ignacio; Perrault, C. M.; Patat, F.; et al.; The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents; American Society of Neuroradiology; American Journal Of Neuroradiology; 39; 2; 2-2018; 323-330
0195-6108
CONICET Digital
CONICET
url http://hdl.handle.net/11336/58078
identifier_str_mv Narata, A. P.; De Moura, F. S.; Larrabide, Ignacio; Perrault, C. M.; Patat, F.; et al.; The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents; American Society of Neuroradiology; American Journal Of Neuroradiology; 39; 2; 2-2018; 323-330
0195-6108
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.3174/ajnr.A5471
info:eu-repo/semantics/altIdentifier/url/http://www.ajnr.org/content/39/2/323
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv American Society of Neuroradiology
publisher.none.fl_str_mv American Society of Neuroradiology
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 12.952241

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