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Effects of different stent wire mesh densities on hemodynamics in aneurysms of different sizes

Intracranial stents are used to treat aneurysms by diverting the blood flow from entering into the aneurysmal dome. Although delayed rupture is rare, clinical outcomes are extremely poor in such cases. Hemodynamics after stent deployment may be related to delayed rupture and a better understanding o...

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Published in:PloS one 2022-06, Vol.17 (6), p.e0269675-e0269675
Main Authors: Masuda, Shunsuke, Fujimura, Soichiro, Takao, Hiroyuki, Takeshita, Kohei, Suzuki, Takashi, Uchiyama, Yuya, Karagiozov, Kostadin, Ishibashi, Toshihiro, Fukudome, Koji, Yamamoto, Makoto, Murayama, Yuichi
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cited_by cdi_FETCH-LOGICAL-c758t-b83f18f1b847c9b01988e2f624f5183af4332cc58d48ec1c48812ab5927cc1b43
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creator Masuda, Shunsuke
Fujimura, Soichiro
Takao, Hiroyuki
Takeshita, Kohei
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Ishibashi, Toshihiro
Fukudome, Koji
Yamamoto, Makoto
Murayama, Yuichi
description Intracranial stents are used to treat aneurysms by diverting the blood flow from entering into the aneurysmal dome. Although delayed rupture is rare, clinical outcomes are extremely poor in such cases. Hemodynamics after stent deployment may be related to delayed rupture and a better understanding of the basic characteristics of pressure changes resulting from stent deployment is needed; therefore, this study investigated the relationships between hemodynamics in aneurysms of different sizes treated using stents of different wire mesh densities. Using computational fluid dynamics analysis, parameters related to velocity, volume flow rate, pressure, and residual volume inside the aneurysm were evaluated in digital models of 5 basic aneurysms of differing sizes (Small, Medium, Medium-Large, Large, and Giant) and using 6 different types of stent (varying number of wires, stent pitch and wire mesh density) for each aneurysm. Regardless of the aneurysm size, the velocity inside the aneurysm and the volume flow rate into the aneurysm were observed to continuously decrease up to 89.2% and 78.1%, respectively, with increasing stent mesh density. In terms of pressure, for giant aneurysms, the pressure on the aneurysmal surface elevated to 10.3%, then decreased to 5.1% with increasing stent mesh density. However, in smaller aneurysms, this pressure continuously decreased with increasing stent mesh density. The flow-diverting effect of the stents was limited when a stent with low mesh density (under 20%) was used with a giant aneurysm. The present results indicate that the selection of appropriate stents according to aneurysm size may contribute to reduced risks of hemodynamic alternations related to stent deployment, which could reduce the incidence of delayed rupture.
doi_str_mv 10.1371/journal.pone.0269675
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subjects Alternations
Aneurysm
Aneurysms
Biology and Life Sciences
Blood
Blood flow
Care and treatment
Carotid arteries
Complications and side effects
Computational fluid dynamics
Computer applications
Density
Design
Finite element method
Flow rates
Flow velocity
Fluid dynamics
Hemodynamics
Humans
Hydrodynamics
Implants
Intracranial Aneurysm
Measurement
Medicine and Health Sciences
Patient outcomes
Physical Sciences
Pressure
Pressure changes
Reynolds number
Risk reduction
Rupture
Rupturing
Stent (Surgery)
Stents
Surgical Mesh
Turbulence models
Veins & arteries
Velocity
Wire
Wire cloth
Wire netting
title Effects of different stent wire mesh densities on hemodynamics in aneurysms of different sizes
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