Risk Factors for Recanalization after Coil Embolization

Journal of Personalized Medicine

Bartłomiej Tomasik¹  Ernest J. Bobeff²  Bartłomiej J. Posmyk²  Dariusz J. Jaskólski²  Karol Wiśniewski²  Marlena Hupało²  Ludomir Stefańczyk³  Zbigniew Tyfa⁴  Piotr Reorowicz⁴  Krzysztof Jóźwik⁴ 

[1] Department of Biostatistics and Translational Medicine, Medical University of Lodz, 15 Mazowiecka St., 92-215 Lodz, Poland;Department of Neurosurgery and Neurooncology, Medical University of Lodz, Kopcińskiego 22, 90-153 Lodz, Poland;Department of Radiology-Diagnostic Imaging, Medical University of Lodz, Kopcińskiego 22, 90-153 Lodz, Poland;Institute of Turbomachinery, Medical Apparatus Division, Lodz University of Technology, Wolczanska 219/223, 90-924 Lodz, Poland;

关键词: embolization;    coils;    recanalization;    predictors;    computational fluid dynamics;    complex flow patterns;   

DOI  :  10.3390/jpm11080793

来源: DOAJ

【 摘 要 】

The aim of our study was to identify risk factors for recanalization 6 months after coil embolization using clinical data followed by computational fluid dynamics (CFD) analysis. Methods: Firstly, clinical data of 184 patients treated with coil embolization were analyzed retrospectively. Secondly, aneurysm models for high/low recanalization risk were generated based on ROC curves and their cut-off points. Afterward, CFD was utilized to validate the results. Results: In multivariable analysis, aneurysm filling during the first embolization was an independent risk factor whilst packing density was a protective factor of recanalization after 6 months in patients with aSAH. For patients with unruptured aneurysms, packing density was found to be a protective factor whilst the aneurysm neck size was an independent risk factor. Complex flow pattern and multiple vortices were associated with aneurysm shape and were characteristic of the high recanalization risk group. Conclusions: Statistical analysis suggested that there are various factors influencing recanalization risk. Once certain values of morphometric parameters are exceeded, a complex flow with numerous vortices occurs. This phenomenon was revealed due to CFD investigations that validated our statistical research. Thus, the complex flow pattern itself can be treated as a relevant recanalization predictor.

【 授权许可】

Unknown