Evidence map›Paper›PMID 36193892›Full record

ArticleJournal of biomechanical engineering2023

Modeling the Mechanical Microenvironment of Coiled Cerebral Aneurysms.

David I Bass, Laurel M M Marsh, Patrick Fillingham, Do Lim, V Keshav Chivukula, Louis J Kim, Alberto Aliseda, Michael R Levitt

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of biomechanical engineering, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David I BassDepartment of Neurological Surgery, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104.
Laurel M M MarshDepartment of Mechanical Engineering, University of Washington, 3900 East Stevens Way NE, Box 352600, Seattle, WA 98195.
Patrick FillinghamDepartment of Neurological Surgery, Stroke & Applied Neuroscience Center, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104.
Do LimDepartment of Neurological Surgery, Stroke & Applied Neuroscience Center, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104.
V Keshav ChivukulaDepartment of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, 150 West University Building, Melbourne, FL 32901.
Louis J KimDepartment of Neurological Surgery, Stroke & Applied Neuroscience Center, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104; Department of Radiology, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104.
Alberto AlisedaDepartment of Mechanical Engineering, Stroke & Applied Neuroscience Center, University of Washington, 3900 East Stevens Way NE, Box 352600, Seattle, WA 98195; Department of Neurological Surgery, Stroke & Applied Neuroscience Center, University of Washington, 3900 East Stevens Way NE, Box 352600, Seattle, WA 98195.
Michael R LevittDepartment of Neurological Surgery, Stroke & Applied Neuroscience Center, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104; Department of Radiology, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104; Department of Mechanical Engineering, University of Washington, 325 9th Avenue, Box 359924, Seattle, WA 98104.

Funding

Improving the computational modeling of coiled cerebral aneurysms through synchrotron microtomographyR01NS105692 · NINDS · UNIVERSITY OF WASHINGTON · PI Michael Robert Levitt · 2018 to 2026
$3.5M
Neurosurgery research training in interdisciplinary neuroscienceR25NS079200 · NINDS · UNIVERSITY OF WASHINGTON · PI OJEMANN, JEFFREY G · 2012 to 2021
$1.2M
NINDS NIH HHS R01 NS105692NINDS NIH HHS R25 NS079200
6 · The paper itself

Abstract

Successful occlusion of cerebral aneurysms using coil embolization is contingent upon stable thrombus formation, and the quality of the thrombus depends upon the biomechanical environment. The goal of this study was to investigate how coil embolization alters the mechanical micro-environment within the aneurysm dome. Inertialess particles were injected in three-dimensional, computational simulations of flow inside patient aneurysms using patient-specific boundary conditions. Coil embolization was simulated as a homogenous porous medium of known permeability and inertial constant. Lagrangian particle tracking was used to calculate the residence time and shear stress history for particles in the flow before and after treatment. The percentage of particles entering the aneurysm dome correlated with the neck surface area before and after treatment (pretreatment: R2 = 0.831, P < 0.001; post-treatment: R2 = 0.638, P < 0.001). There was an inverse relationship between the change in particles entering the dome and coil packing density (R2 = 0.600, P < 0.001). Following treatment, the particles with the longest residence times tended to remain within the dome even longer while accumulating lower shear stress. A significant correlation was observed between the treatment effect on residence time and the ratio of the neck surface area to porosity (R2 = 0.390, P = 0.007). The results of this study suggest that coil embolization triggers clot formation within the aneurysm dome via a low shear stress-mediated pathway. This hypothesis links independently observed findings from several benchtop and clinical studies, furthering our understanding of this treatment strategy.

Indexed as

Embolization, TherapeuticIntracranial AneurysmBlood Vessel ProsthesisHumansPorosityTreatment Outcome

Identifiers

PMID36193892
PMCPMC9791668

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.