北京生物醫(yī)學(xué)工程

密網(wǎng)支架治療顱內(nèi)分叉動脈瘤數(shù)值模擬研究

Numerical simulation of intervention for cerebral bifurcate aneurysm by dense braided stent

作者：付文宇李立新任鵬飛喬愛科

單位：北京聯(lián)合大學(xué)機器人學(xué)院( 北京 100027) 北京工業(yè)大學(xué)生命學(xué)院（北京100124）

關(guān)鍵詞：編織支架; 顱內(nèi)分叉動脈瘤; 壁面切應(yīng)力; 血流速度

分類號：R318.04

出版年·卷·期（頁碼）：2020·39·6（561-568）

摘要：

目的對密網(wǎng)支架虛擬植入顱內(nèi)分叉動脈瘤過程進行數(shù)值模擬研究，探討植入密網(wǎng)支架對顱內(nèi)分叉動脈瘤腔的血流動力學(xué)的影響，為密網(wǎng)支架是否適合介入治療顱內(nèi)分叉動脈瘤進行初步的力學(xué)計算研究。方法利用有限元軟件ABAQUS模擬密網(wǎng)支架植入顱內(nèi)分叉動脈瘤的過程，得到變形后的支架模型。在ANSYS CFX中對顱內(nèi)分叉動脈瘤模型及植入密網(wǎng)支架的分叉動脈瘤模型進行流體計算，比較植入支架前后動脈瘤腔中流線變化情況、瘤腔中血流平均速度值，動脈瘤壁面壓力及壁面切應(yīng)力變化情況。結(jié)果支架-微導(dǎo)管模型可以很好地模擬植入全過程。特別發(fā)現(xiàn)在載瘤動脈局部支架和血管壁貼合不良; 植入支架后動脈瘤腔平均血流速度在收縮期加速和減速階段分別降低了71.4%和17.2%；植入支架后動脈瘤面切應(yīng)力降低了，但壁面壓力略有增加。結(jié)論密網(wǎng)支架可降低顱內(nèi)分叉動脈瘤腔血流速度，但需特別關(guān)注密網(wǎng)支架和載瘤動脈局部貼合不良問題，其有可能導(dǎo)致載瘤動脈狹窄。

Objective The numerical simulation of the process that the braided stent is virtually implanted into the intracranial bifurcation aneurysm is carried out. The hemodynamics of the aneurismal cavity before and after the implantation of the braided stent are compared. A preliminary study of mechanical calculation is carried out whether the dense stent is suitable for interventional treatment of cerebral bifurcate aneurysm. Methods The finite element software ABAQUS is used to simulate the process of implanting dense braided stent into intracranial bifurcation aneurysm and obtaining stent model which is implanted into parent artery. ANSYS CFX is used to perform fluid calculations on the intracranial bifurcation aneurysm model and the bifurcate aneurismal model which is implanted with dense braided stent. The changes of streamlines and the average speed of blood flow in the aneurismal cavity before and after the stent implantation, and the changes of the pressure and the wall shear stress on aneurismal wall were compared. Results The whole implantation process of the stent-microcatheter model is well simulated. In particular, poor apposition between stent and vessel walls are found in parent artery locally. After the braided stent implantation, the mean blood flow speed in the aneurismal cavity decreased by 71.4% and 17.2% during the systolic acceleration and deceleration phases, respectively. After the implantation of the braided stent, the aneurismal wall shear stress is reduced, but the wall pressure increases slightly. Conclusions The dense braided stent can reduce the blood flow speed in the intracranial bifurcate aneurismal cavity. Special attention needs to be paid to the poor apposition between the braided stent and the parent artery, which may lead to narrowing of the parent artery.

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