Indivisualized risk assessment of recanalization of visceral aneurysms using hemodynamic analysis

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K16718
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Tohoku University
• Principal Investigator: Kamada Hiroki 東北大学, 大学病院, 医員 (00789836)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 内臓動脈瘤 / 血流シミュレーション / 血管内治療 / 再開通

Outline of Final Research Achievements

We investigated the risk of recanalization in 6 patients with visceral aneurysm embolization using coil packing. Blood flow simulations were performed using anatomically realistic vessel geometry created from the patient's CT images. A porous media model that represented flow in the embolized aneurysmal region was employed. Stagnant volume ratio (SVR) was used to quantify the flow stagnation within the aneurysm. SVR was elevated, with increased packing density (PD), in all patients. In the patient with recanalization, the rate of increase in SVR for PD < 20% was smaller than that in the other five other patients, and the SVR for the actual PD was the lowest. In the 5 patients without recanalization, the SVR for the actual PD was greater than 80% at Reynolds number of 300. The result suggests that our blood flow simulations focusing on SVR would be useful to determine the clinical endpoint, the optimum individualized PD and to optimize postoperative follow-up of visceral aneurysms.

Free Research Field

作成中

Academic Significance and Societal Importance of the Research Achievements

医用画像と血流シミュレーションを援用することで，内臓動脈瘤の塞栓後の最開通リスクの評価を行った．内臓動脈瘤は比較的珍しい疾患で，コイルパッキングによる塞栓術を施行する症例は少ない．本研究で示したシミュレーションを用いることで、症例の蓄積が困難な内臓動脈瘤の塞栓術の最適なコイル充填率の選択や治療後のfollow-up最適化に有用な指標となる可能性が示された．