Prediction of internal carotid artery aneurysm recurrence by pressure difference at the coil mass surface
- PDF / 2,558,404 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 49 Downloads / 191 Views
INTERVENTIONAL NEURORADIOLOGY
Prediction of internal carotid artery aneurysm recurrence by pressure difference at the coil mass surface Takehiro Uno 1 & Kouichi Misaki 1 & Iku Nambu 1 Naoyuki Uchiyama 1 & Mitsutoshi Nakada 1
&
Akifumi Yoshikawa 1 & Tomoya Kamide 1
&
Received: 16 June 2020 / Accepted: 8 September 2020 # The Author(s) 2020
Abstract Purpose A previous study on computational fluid dynamics reported that a high pressure difference (PD) at the surface of a coil mass is a strong predictor of aneurysm recurrence after coil embolization. PD was calculated using a virtual post-coiling model (VM), created by manually cutting the aneurysm by the flat plane from an anatomic model created with pre-coil embolization data; however, its credibility has not been fully evaluated. This study aims to clarify whether PD values calculated using the postcoiling model, which reflects the actual coil plane, are a strong predictor of aneurysm recurrence. Methods Fifty internal carotid artery aneurysms treated with endovascular coil embolization were analyzed (7 recanalized, 43 stable). We created and subjected two post-coiling models, namely, VM and the real post-coiling model (RM), constructed from the post-coil embolization data. The relationship between PD and aneurysm recurrence was examined using these models. PD and its constituent three parameters were compared between VM and RM. Results PD values calculated using RM showed significantly higher aneurysm recurrence in recurrence group than stable group (p < 0.001), and multivariate analysis showed that PD in RM (p = 0.02; odds ratio, 36.24) was significantly associated with aneurysm recurrence. The receiver operating characteristic analysis revealed that PD values accurately predicted aneurysm recurrence (area under the curve, 0.977; cutoff value, 3.08; sensitivity, 100%; specificity, 97.7%). All four parameters showed a significant correlation with VM and RM (p < 0.001). Conclusion Use of PD to predict recurrence after coil embolization can be clinically relevant. Keywords Pressure difference . Virtual post-coiling model . Intracranial aneurysm . Computational fluid dynamics . Recurrence after coil embolization
Abbreviations 3D-RA Three-dimensional rotational angiography AUC Area under the curve CE-MRA Contrast-enhanced magnetic resonance angiography CFD Computational fluid dynamics DICOM Digital imaging for communication in medicine DSA Digital subtraction angiography
ICA PcomA PD RM ROC TOF-MRA
* Kouichi Misaki [email protected]
Introduction
1
Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
VER VM
Internal carotid artery Posterior communicating artery Pressure difference Real post-coiling model Receiver operating characteristic Time-of-flight magnetic resonance angiography Volume embolization ratio Virtual post-coiling model
Endovascular coil embolization is a safe and reliable technique for intracranial aneurysm treatment [1, 2]. However, aneurysms ar
Data Loading...
