Image-based computational hemodynamic analysis of an anterior communicating aneurysm treated with the Woven EndoBridge device

Abstract

Background: The Woven EndoBridge (WEB) aneurysm embolization device is a relatively recent developed intrasaccular flow disruptor committed to intracranial wide-neck and complex aneurysm occlusion. In this study, we aimed to assess hemodynamic profiles of an AcomA aneurysm treated with WEB Single Layer (WEB-SL) to shed light on the understanding of hemodynamic alterations in the context of a recanalized aneurysm. Methods: Image-Based computational fluid dynamics (CFD) was used to simulate pre and post-treatment blood flow of an anterior communicating aneurysm treated with WEB-SL. The simulated velocity field was used to visualize and quantify velocity, wall shear stress (WSS), and pressure distributions. Results: Following WEB deployment, infiltration of flow and mean velocity magnitude were decreased considerably within the aneurysm sac. WSS was the only measured index that demonstrated a dual hemodynamic pattern; it reduced along the superior half of the aneurysm sac while slightly increased in the neck region. At one-year follow-up, angiography showed recanalization of the aneurysm, and the WEB had been pushed to the dome. Conclusions: All assessed hemodynamic parameters reduced significantly from pre to post-WEB placement in the sac of AcomA aneurysm; however, recanalization may happen secondary to filling the proximal portion of the WEB-SL and increased WSS in the neck of the aneurysm. Conduction of larger studies is warranted to elaborately investigate the potential role of CFD techniques for correlating the hemodynamics indices with clinical outcomes.

Keywords

• Computational fluid dynamics
• Interventional neurosurgery
• Intracranial aneurysm
• Woven Endobridge
• WEB