密网支架对颅内动脉瘤血流动力学影响的数值模拟分析

      Numerical Simulation Analysis of the Hemodynamic Effects of Stent on Intracranial Aneurysms

      • 摘要: 颅内动脉瘤破裂的致死率和致残率极高,血流导向密网支架以其低孔率设计改变瘤内血流动力学环境,已成为介入治疗的核心技术。本研究采用数值模拟方法,结合临床脉动血流边界条件,对囊状与梭形动脉瘤在植入密网支架前后的血流速度、壁面剪切应力(WSS)及涡流结构的动态变化进行了对比分析。研究结果显示,支架植入后,囊状动脉瘤内血流速度最大降幅达57.4%,梭形动脉瘤近端流速降低57.7%;瘤内WSS显著下降,最高降幅59.2%,且涡流复杂度显著降低。此外,本研究对植入支架前后血流动力学参数的变化和定量分析,总结讨论了支架对瘤腔血流速度与WSS的调控机制、动脉瘤形态对支架调控效应的差异化机制和心动周期动态响应的临床转化价值,为未来临床治疗提供了相应的理论依据。

         

        Abstract: The rupture of intracranial aneurysms is associated with extremely high mortality and disability rates. Flow diverter stents, characterized by their low-porosity design that modulates the intraluminal hemodynamic environment, have emerged as a core technology in interventional therapy. In this study, numerical simulation approaches were employed, integrated with clinical pulsatile blood flow boundary conditions, to conduct a comparative analysis of the dynamic changes in blood flow velocity, wall shear stress (WSS), and vortex structures in saccular and fusiform aneurysms before and after flow diverter stent implantation. The findings revealed that following stent deployment, the maximum reduction in intrasaccular blood flow velocity reached 57.4%, while the proximal flow velocity in fusiform aneurysms decreased by 57.7%. Intraluminal WSS exhibited a significant decline, with the highest reduction of 59.2%, and the complexity of vortex structures was markedly diminished. Furthermore, through the analysis of changes in hemodynamic parameters and their quantitative assessment pre- and post-stent implantation, this study summarized and discussed the regulatory mechanisms of stents on intraluminal blood flow velocity and WSS, the differential mechanisms underlying the stent's regulatory effects based on aneurysm morphology, and the clinical translational value of dynamic responses throughout the cardiac cycle. These insights provide a theoretical foundation for future clinical interventions.

         

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