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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleExpedited Publication

Aneurysm Rupture Following Treatment with Flow-Diverting Stents: Computational Hemodynamics Analysis of Treatment

J.R. Cebral, F. Mut, M. Raschi, E. Scrivano, R. Ceratto, P. Lylyk and C.M. Putman
American Journal of Neuroradiology January 2011, 32 (1) 27-33; DOI: https://doi.org/10.3174/ajnr.A2398
J.R. Cebral
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F. Mut
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M. Raschi
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E. Scrivano
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R. Ceratto
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P. Lylyk
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C.M. Putman
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  • Fig 1.
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    Fig 1.

    Rotational angiograms prior and immediately after stent placement and corresponding vascular models of 3 aneurysms associated with posttreatment rupture. Top row, patient 1, left to right: 3DRA before treatment, vascular pretreatment model, 3DRA without contrast after stent deployment, and vascular posttreatment model. Center row, patient 2, left to right: 3DRA before treatment, 3DRA without contrast after stent deployment, vascular posttreatment model, and stent design. Bottom row, patient 3, left to right: 3DRA before treatment, vascular pretreatment model, 3DRA after stent placement, and vascular posttreatment model.

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    Fig 2.

    Rotational angiograms and computational models of 4 aneurysms successfully treated with flow diverters. Left to right: 3DRA image before treatment, computational model with stent in place, 3DRA without contrast showing the deployed stents, and follow-up 3DRA images. Rows top to bottom correspond to patients 4–7, respectively.

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    Fig 3.

    Visualizations of the hemodynamics of patients 1–3 at peak systole before (left column) and after (right column) stent placement. Top to bottom: isovelocity surfaces, velocity color-coded streamlines, WSS distribution, and pressure distributions.

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    Fig 4.

    Visualizations of the hemodynamics of patients 4–7 at peak systole before (left column) and after (right column) stent placement. Top to bottom: isovelocity surfaces, velocity color-coded streamlines, WSS distribution, and pressure distributions.

  • Fig 5.
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    Fig 5.

    Electric circuit analog.

Tables

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    Table 1:

    Clinical information

    Patient No.Age (yr)/SexSize (mm)LocationTreatmentOutcome
    162/F26Left ICA superior-hypophyseal1 PED-associated with 50% stenosis treated with PTARuptured at day 4
    254/F25Right ICA ophthalmic1 PEDRuptured intraprocedurally
    360/F38Right ICA ophthalmic2 PED-restricted PAs opened with stentingRuptured at day 7
    459/F3.1Left ICA ophthalmic1 PEDComplete occlusion at 6 mo
    539/F4.6Right ICA superior-hypophyseal1 PEDComplete occlusion at 6 mo
    658/M9.7Left ICA cavernous2 PEDsComplete occlusion at 12 mo
    758/F26Right ICA ophthalmic2 PEDsComplete occlusion at 6 mo
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    Table 2:

    Pressures, resistances, and flow rates corresponding to the electric circuit analog of patient 2 (Fig 5)

    CasePs (mm Hg)Pi (mm Hg)Po (mm Hg)Rp (dyne/s/cm5)Rd (dyne/s/cm5)Ra (dyne/s/cm5)Q (mL/s)ΔP (mm Hg)
    Pre120110100580057,90058002.30–
    Post12011272580055,00023,2001.902
    12511777580055,00023,2001.987
    13012281580055,00023,2002.0612
    13512686580055,00023,2002.1516
    14013090580055,00023,2002.2220
    14513595580055,00023,2002.3025
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American Journal of Neuroradiology: 32 (1)
American Journal of Neuroradiology
Vol. 32, Issue 1
1 Jan 2011
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J.R. Cebral, F. Mut, M. Raschi, E. Scrivano, R. Ceratto, P. Lylyk, C.M. Putman
Aneurysm Rupture Following Treatment with Flow-Diverting Stents: Computational Hemodynamics Analysis of Treatment
American Journal of Neuroradiology Jan 2011, 32 (1) 27-33; DOI: 10.3174/ajnr.A2398

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Aneurysm Rupture Following Treatment with Flow-Diverting Stents: Computational Hemodynamics Analysis of Treatment
J.R. Cebral, F. Mut, M. Raschi, E. Scrivano, R. Ceratto, P. Lylyk, C.M. Putman
American Journal of Neuroradiology Jan 2011, 32 (1) 27-33; DOI: 10.3174/ajnr.A2398
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