What is it about?
This study aimed to investigate the influence of presurgical hemodynamics on the efficacy of coil embolization for basilar tip aneurysms. We identified 57 patients who underwent endovascular coil embolization for basilar tip aneurysms with a follow-up >1 year. Presurgical hemodynamics were investigated using computational fluid dynamics with three-dimensional data derived from rotational angiography. We quantified the rate of net flow entering the aneurysm through its neck and calculated the proportion of the aneurysmal inflow rate to the basilar artery flow rate. In addition, we investigated the correlation between the basilar bifurcation configuration and the hemodynamics. Among the 57 examined patients, angiographic recanalization was observed in 19 patients (33.3%). The proportion of the aneurysmal inflow rate to the basilar artery flow rate and a coil packing density <30% were independent and significant predictors for the recanalization of coiled aneurysms. Additional investigation revealed that a small branch angle formed by the basilar artery and the posterior cerebral artery increased blood flow into the aneurysm.
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Why is it important?
This study demonstrated the correlation between the hemodynamics before coil embolization and the outcome after treatment for basilar tip aneurysms. In addition, we demonstrated that the aneurysmal hemodynamics depended on the configuration of the parent arteries.
Perspectives
We plan to conduct a multicenter prospective study to confirm the findings of this study. If validated in a prospective manner, the predictive baseline hemodynamic properties have the potential to alter clinical management.
Dr. Shin-ichiro Sugiyama
Tohoku University Graduate School of Medicine
Read the Original
This page is a summary of: Blood Flow Into Basilar Tip Aneurysms, Stroke, September 2016, Wolters Kluwer Health,
DOI: 10.1161/strokeaha.116.013555.
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