Prediction of Post-Embolization Recurrence of Anterior Communicating Aneurysms with A1 Segment Asymmetry by Fluid Dynamic Analysis
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- Misaki Kouichi
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
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- Uno Takehiro
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
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- Nambu Iku
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
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- Yoshikawa Akifumi
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
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- Kamide Tomoya
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
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- Uchiyama Naoyuki
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
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- Nakada Mitsutoshi
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
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説明
<p>Objective: The increased surface pressure of the coil mass calculated by computational fluid dynamics (CFD) analysis has been reported to be associated with the recurrence of internal carotid aneurysms after coil embolization. In this study, we investigated the relationship between the pressure on the coil surface and the recurrence of anterior communicating aneurysms.</p><p>Methods: Among patients with anterior communicating aneurysms who underwent coil embolization at a volume embolization rate of 20% or more without using a stent, only one proximal anterior communicating artery (A1) was visualized by magnetic resonance angiography (MRA). A virtual post-coiling model was created by eliminating the aneurysm at the neck position from the blood vessel model based on three-dimensional rotational angiography (3D-RA) data before treatment, and the neck plane was defined as the virtual coil plane. Using CFD analysis, the pressure difference (PD) was calculated by subtracting the average pressure of A1 from the maximum pressure on the virtual coil surface and dividing by the dynamic pressure of A1 for normalization. PD was statistically compared between the recurrent group and the non-recurrent group.</p><p>Results: Four of 10 patients with anterior communicating aneurysms exhibited recurrence. The PD was 2.54 ± 0.24 and 2.12 ± 0.26 in the recurrent and non-recurrent groups, respectively, and was significantly higher in the recurrent group (p=0.038). In the receiver operating characteristics (ROC) analysis, the area under the curve (AUC) was 0.917, and with a cutoff value of 2.31, the sensitivity was 1.000 and the specificity was 0.833.</p><p>Conclusion: PD was considered a predictor of recurrence after coil embolization in anterior communicating aneurysms with asymmetrical A1. Preoperative prediction of recurrence after cerebral aneurysm embolization may be possible using CFD analysis.</p>
収録刊行物
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- 脳神経血管内治療
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脳神経血管内治療 15 (2), 71-76, 2021
一般社団法人 日本脳神経血管内治療学会
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詳細情報 詳細情報について
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- CRID
- 1390287142243217408
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- NII論文ID
- 130007988670
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- NII書誌ID
- AA1229439X
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- ISSN
- 21862494
- 18824072
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- NDL書誌ID
- 031298114
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- 本文言語コード
- en
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- 資料種別
- journal article
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- データソース種別
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- NDLサーチ
- Crossref
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- OpenAIRE
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