Development of endovascular treatment for giant cerebral aneurysm employing virtual engineering approach

2023 Fiscal Year Final Research Report

• Project/Area Number: 18K08949
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56010:Neurosurgery-related
• Research Institution: Jichi Medical University
• Principal Investigator: Yoshino Yoshikazu 自治医科大学, 医学部, 教授 (70323681)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Keywords: Brain Aneurysm / Endovascular Surgery / Embolization / Virtual Engineering / CFD / Computer Aided Design

Outline of Final Research Achievements

As a morphological feature of cerebral aneurysms, the more acute the 3D positional relationship between the aneurysm’s central axis and the running axis of the parent vessel along the blood flow, the lower the WSS (Wall Shear Stress) within the aneurysm and the higher the average OSI (Oscillatory Shear Index). Furthermore, not only the shape of the central vessel on the proximal side but also the shape on the distal side and the running axis relative to the aneurysm’s central axis influence the blood flow parameters of the aneurysm, revealing that the impact on the aneurysm due to model modifications is multifaceted. In particular, 3D vascular deviation that alleviates the curvature of the distal vessels tended to increase WSS and decrease OSI of the aneurysm wall. These findings suggest that alleviating the curvature of the distal vessel promotes the healing process of the aneurysm and leading to the development of new treatment approach potentially.

Free Research Field

脳神経血管内治療学分野

Academic Significance and Societal Importance of the Research Achievements

大型の脳動脈瘤に対する外科治療は困難を極め自然経過による予後も悪い。標準的な血管内治療としてコイル塞栓術やflow diverter stentがあるが、これらは脳動脈瘤の発生要因に対する根本的な治療ではないため、大型脳動脈瘤では治療成績が十分でない。本研究結果は、動脈瘤が発生する根本要因を改変させる治療につながるもので、これまでの血管内治療治とは発想が異なる独創的なものである。またVirtual Engineeringの手法を用いた本研究は動物実験のプロセスを省略した効率的な実験が可能でる。将来的には個々の症例に最適化したデバイスを用いて治療を行う新時代の治療法に発展する可能性がある。