Implementation of computer simulation to assess flow diversion treatment outcomes: Systematic review and meta-analysis

Mingzi Zhang, Simon Tupin, Hitomi Anzai, Yutaro Kohata, Masaaki Shojima, Kosuke Suzuki, Yoshihiro Okamoto, Katsuhiro Tanaka, Takanobu Yagi, Soichiro Fujimura, Makoto Ohta

研究成果: Review article査読

4 被引用数 (Scopus)

抄録

Introduction Despite a decade of research into virtual stent deployment and the post-stenting aneurysmal hemodynamics, the hemodynamic factors which correlate with successful treatment remain inconclusive. We aimed to examine the differences in various post-treatment hemodynamic parameters between successfully and unsuccessfully treated cases, and to quantify the additional flow diversion achievable through stent compaction or insertion of a second stent. Methods A systematic review and meta-analysis were performed on eligible studies published from 2000 to 2019. We first classified cases according to treatment success (aneurysm occlusion) and then calculated the pooled standardized mean differences (SMD) of each available parameter to examine their association with clinical outcomes. Any additional flow diversion arising from the two common strategies for improving the stent wire density was quantified by pooling the results of such studies. Results We found that differences in the aneurysmal inflow rate (SMD -6.05, 95% CI -10.87 to -1.23, p=0.01) and energy loss (SMD -5.28, 95% CI -7.09 to -3.46, p<0.001) between the successfully and unsuccessfully treated groups were indicative of statistical significance, in contrast to wall shear stress (p=0.37), intra-aneurysmal average velocity (p=0.09), vortex core-line length (p=0.46), and shear rate (p=0.09). Compacting a single stent could achieve additional flow diversion comparable to that by dual-stent implantation. Conclusions Inflow rate and energy loss have shown promise as identifiers to discriminate between successful and unsuccessful treatment, pending future research into their diagnostic performance to establish optimal cut-off values.

本文言語English
ページ(範囲)164-170
ページ数7
ジャーナルJournal of NeuroInterventional Surgery
13
2
DOI
出版ステータスPublished - 2021 2 1

ASJC Scopus subject areas

  • 外科
  • 臨床神経学

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