Recurrence of coiled intracranial aneurysms; wall shear stress in pre- and post-coiling aneurysms.

Csizmadia, M. (Marloes) (2014) Recurrence of coiled intracranial aneurysms; wall shear stress in pre- and post-coiling aneurysms. thesis, Medicine.

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Abstract

Introduction. Recurrence is a significant problem in intracranial aneurysms treated with endovascular coiling. Currently there is no method for predicting recurrence of treated aneurysms. Previous studies associated high wall shear stress (WSS) and blood flow velocity near remnant necks of aneurysms with recurrence. Because, aneurysms with high WSS after treatment are associated with recurrence, we investigated whether pre-treatment WSS patterns can predict post-treatment WSS. If high WSS patterns before treatment are indicative for the origination of high WSS patterns after treatment, this measurement can be used to steer treatment. Method. For this retrospective observational cohort study we studied 13 patients with endovascular coiled aneurysms with recurrence. Computational Fluid Dynamics (CFD) simulations were performed to simulate blood flow in patient-specific vascular models based on 3DRA image and DSA data and by using patient specific velocities profiles measured by phase-contrast MRI. The mean WSS near the neck before and after endovascular coiling was compared. Statistical analysis was performed using the Wilcoxon-signed rank test. Results. Post-treatment mean WSS increased in all 13 patients compared to pre-treatment mean WSS. The median difference of pre- and post-treatment mean WSS was 5.75 [IQR: 2.43 - 0.34]. This difference was statistically significant (p=0.001) Conclusion. Pre-treatment WSS cannot be used to predict post-treatment WSS values, and therefore cannot be used to predict long-term outcome after endovascular coiling of intracranial aneurysms.

Item Type:	Thesis (Thesis)
Supervisor name:	Nijholt, Dr. I.M.
Supervisor name:	Marquering, Dr. H. and Majoie, Prof. Dr. C. and Berg, Dr. R. van den and AMC Amsterdam
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:54
Last Modified:	25 Jun 2020 10:54
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1478

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