Aneurysmal recanalization and coil compaction after coil embolization of intracranial aneurysms are seen in as many as 40% of cases. Higher packing density has been suggested to reduce both coil compaction and recanalization. Basilar bifurcation aneurysms remain a challenge due possibly to the hemodynamics of this specific aneurysm/parent vessel architecture, which subjects the coil mass at the aneurysm neck to elevated and repetitive impingement forces. In the present study, we propose a new modeling strategy that facilitates a better understanding of the complex interactions between detachable coils and the local blood flow. In particular, a semiheuristic porous media set of equations used to describe the intra-aneurysmal flow is coupled to the incompressible Navier–Stokes equations governing the dynamics of the flow in the involved vessels. The resulting system of equations is solved in a strongly coupled manner using a finite element formulation. Our results suggest that there is a complex interaction between the local hemodynamics and intra-aneurysmal flow that induces significant forces on the coil mass. Although higher packing densities have previously been advocated to reduce coil compaction, our simulations suggest that lower permeability of the coil mass at a given packing density could also promote faster intra-aneurysmal thrombosis due to increased residence times.

1.
Guglielmi
,
G.
,
Viuela
,
F.
,
Sepetka
,
I.
, and
Macellari
,
V.
, 1991, “
Electrothrombosis of Saccular Aneurysms Via Endovascular Approach. Part 1: Electrochemical Basis, Technique, and Experimental Results
,”
J. Neurosurg.
0022-3085,
75
(
1
), pp.
1
9
.
2.
Murayama
,
Y.
,
Nien
,
Y. L.
,
Duckwiler
,
G.
,
Gobin
,
P. Y.
,
Jahan
,
R.
,
Frazer
,
J.
,
Martin
,
N.
, and
Viuela
,
F.
, 2003, “
Guglielmi Detachable Coil Embolization of Cerebral Aneurysms, 11Years Experience
,”
J. Neurosurg.
0022-3085,
98
, pp.
959
966
.
3.
Gonzalez
,
N.
,
Murayama
,
Y.
,
Nien
,
Y. L.
,
Martin
,
N.
,
Frazee
,
J.
,
Duckwiler
,
G.
,
Jahan
,
R.
,
Gobin
,
Y. P.
, and
Viuela
,
F.
, 2004, “
Treatment of Unruptured Aneurysms With GDCs, Clinical Experience With 247 Aneurysms
,”
AJNR Am. J. Neuroradiol.
0195-6108,
25
(
4
), pp.
577
583
.
4.
Molyneux
,
A.
,
Kerr
,
R.
,
Stratton
,
I.
,
Sandercock
,
P.
,
Clarke
,
M.
,
Shrimpton
,
J.
, and
Holman
,
R.
, 2002, “
International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International Subarachnoid Aneurysm Trial (ISAT) of Neurosurgical Clipping Versus Endovascular Coiling in 2143 Patients With Ruptured Intracranial Aneurysms, A Randomised Trial
,”
Lancet
0140-6736,
360
, pp.
1267
1274
.
5.
Wiebers
,
D. O.
,
Whisnant
,
J. P.
,
Huston
,
J.
, III
,
Meissner
,
I.
,
Brown
,
R. D.
, Jr.
,
Piepgras
,
D. G.
,
Forbes
,
G. S.
,
Thielen
,
K.
,
Nichols
,
D.
,
O’Fallon
,
W. M.
,
Peacock
,
J.
,
Jaeger
,
L.
,
Kassell
,
N. F.
,
KongableBeckman
,
G. L.
, and
Torner
,
J. C.
, 2003, “
International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured Intracranial Aneurysms: Natural History, Clinical Outcome, and Risks of Surgical and Endovascular Treatment
,”
Lancet
0140-6736,
362
(
9378
), p.
901
;
Wiebers
,
D. O.
,
Whisnant
,
J. P.
,
Huston
,
J.
, III
,
Meissner
,
I.
,
Brown
,
R. D.
, Jr.
,
Piepgras
,
D. G.
,
Forbes
,
G. S.
,
Thielen
,
K.
,
Nichols
,
D.
,
O’Fallon
,
W. M.
,
Peacock
,
J.
,
Jaeger
,
L.
,
Kassell
,
N. F.
,
KongableBeckman
,
G. L.
, and
Torner
,
J. C.
,
Surg. Neurol.
0090-3019,
62
(
2
), pp.
103
110
.
6.
Viuela
,
F.
,
Duckwiler
,
G.
, and
Mawad
,
M.
, 1997, “
Guglielmi Detachable Coil Embolization of Acute Intracranial Aneurysm: Perioperative Anatomical and Clinical Outcome in 403 Patients
,”
J. Neurosurg.
0022-3085,
86
(
3
), pp.
475
482
.
7.
Cognard
,
C.
,
Weill
,
A.
,
Spelle
,
L.
,
Piotin
,
M.
,
Castaings
,
L.
,
Rey
,
A.
, and
Moret
,
J.
, 1999, “
Longterm Angiographic Follow-Up of 169 Intracranial Berry Aneurysms Occluded With Detachable Coils
,”
Radiology
0033-8419,
212
, pp.
348
356
.
8.
Sluzewski
,
M.
,
van Rooij
,
W. J.
,
Rinkel
,
G. J.
, and
Wijnalda
,
D.
, 2003, “
Endovascular Treatment of Ruptured Intracranial Aneurysms With Detachable Coils: Long Term Clinical and Serial Angiographic Results
,”
Radiology
0033-8419,
227
, pp.
720
724
.
9.
Raymond
,
J.
,
Guilbert
,
F.
,
Weill
,
A.
,
Georganos
,
S. A.
,
Juravsky
,
L.
,
Lambert
,
A.
,
Lamoureux
,
J.
,
Chagnon
,
M.
, and
Roy
,
D.
, 2003, “
Longterm Angiographic Recurrences After Selective Endovascular Treatment of Aneurysms With Detachable Coils
,”
Stroke
0039-2499,
34
, pp.
1398
1403
.
10.
Mericle
,
R. A.
,
Wakhloo
,
A. K.
,
Lopes
,
D. K.
,
Lanzino
,
G.
,
Guterman
,
L. G.
, and
Hopkins
,
L. N.
, 1998, “
Delayed Aneurysm Regrowth and Recanalization After Guglielmi Detachable Coil Treatment: Case Report
,”
J. Neurosurg.
0022-3085,
89
, pp.
142
145
.
11.
Turjman
,
F.
,
Massoud
,
T. F.
,
Sayre
,
J.
, and
Vinuela
,
F.
, 1998, “
Predictors of Aneurysmal Occlusion in the Period Immediately After Endovascular Treatment With Detachable Coils: A Multivariate Analysis
,”
AJNR Am. J. Neuroradiol.
0195-6108,
19
(
9
), pp.
1645
1651
.
12.
Hope
,
J. K.
,
Byrne
,
J. V.
, and
Molyneux
,
A. J.
, 1999, “
Factors Influencing Successful Angiographic Occlusion of Aneurysms Treated by Coil Embolization
,”
AJNR Am. J. Neuroradiol.
0195-6108,
20
(
3
), pp.
391
399
.
13.
Lieber
,
B. B.
,
Sadasivan
,
C.
,
Gounis
,
M. J.
, and
Wakhloo
,
A. K.
, 2003, “
The Role of Blood Impulse in Cerebral Aneurysm Coil Compaction: The Effect of Aneurysm Neck Size
,”
Proceedings of the 2003 ASME International Mechanical Engineering Conference and Exposition
,
Washington, DC
, Nov. 16–21.
14.
Mawad
,
M. E.
,
Mawad
,
J. K.
,
Cartwright
,
J.
, Jr.
, and
Gokaslan
,
Z.
, 1995, “
Longterm Histopathologic Changes in Canine Aneurysms Embolized With Guglielmi Detachable Coils
,”
AJNR Am. J. Neuroradiol.
0195-6108,
16
(
1
), pp.
9
13
.
15.
Reul
,
J.
,
Weis
,
J.
,
Spetzger
,
U.
,
Konert
,
T.
,
Fricke
,
C.
, and
Thron
,
A.
, 1997, “
Long-Term Angiographic and Histopathologic Findings in Experimental Aneurysms of the Carotid Bifurcation Embolized With Platinum and Tungsten Coils
,”
AJNR Am. J. Neuroradiol.
0195-6108,
18
(
1
), pp.
35
42
.
16.
Kallmes
,
D. F.
,
Helm
,
G. A.
,
Hudson
,
S. B.
,
Altes
,
T. A.
,
Do
,
H. M.
,
Mandell
,
J. W.
, and
Cloft
,
H. R.
, 1999, “
Histologic Evaluation of Platinum Coil Embolization in an Aneurysm Model in Rabbits
,”
Radiology
0033-8419,
213
, pp.
217
222
.
17.
Boecher-Schwarz
,
H. G.
,
Ringel
,
K.
,
Kopacz
,
L.
, and
Kempski
,
O.
, 2000, “
Ex Vivo Study of the Physical Effect of Coils on Pressure and Flow Dynamics in Experimental Aneurysms
,”
AJNR Am. J. Neuroradiol.
0195-6108,
21
, pp.
1532
1536
.
18.
Canton
,
G.
,
Levy
,
D.
, and
Lasheras
,
J. C.
, 2005, “
Changes in the Intraaneurysmal Pressure due to HydroCoil Embolization
,”
AJNR Am. J. Neuroradiol.
0195-6108,
26
, pp.
904
907
.
19.
Groden
,
C.
,
Laudan
,
J.
,
Gatchell
,
S.
, and
Zeumer
,
H.
, 2001, “
Three-Dimensional Pulsatile Flow Simulation Before and After Endovascular Coil Embolization of a Terminal Cerebral Aneurysm
,”
J. Cereb. Blood Flow Metab.
0271-678X,
21
(
12
), pp.
1464
1471
.
20.
Gobin
,
Y. P.
,
Counord
,
J. L.
,
Flaud
,
P.
, and
Duffaux
,
J.
, 1994, “
In Vitro Study of Hemodynamics in a Giant Saccular Aneurysm Model: Influence of Flow Dynamics in the Parent Vessel and Effects of Coil Embolization
,”
Neuroradiology
0028-3940,
36
, pp.
530
536
.
21.
Cebral
,
J. R.
, and
Lohner
,
R.
, 2005, “
Efficient Simulation of Blood Flow Past Complex Endovascular Devices Using an Adaptive Embedding Technique
,”
IEEE Trans. Med. Imaging
0278-0062,
24
, pp.
468
476
.
22.
Brinkman
,
H. C.
, 1948, “
Calculations of the Flow of Heterogeneous Mixture Through Porous Media
,”
Appl. Sci. Res.
0003-6994,
2
, pp.
81
86
.
23.
Forchheimer
,
P.
, 1901, “
Water Movement Through the Ground
,”
Zeitschrift des Vereines Deutscher Ingenieure
,
45
, pp.
1781
1788
.
24.
Kaviany
,
M.
, 1995,
Principles of Heat Transfer in Porous Media
,
2nd ed.
,
Springer
,
New York
.
25.
Choi
,
H. G.
,
Choi
,
H.
, and
Yoo
,
J. Y.
, 1997, “
A Fractional Four-Step Finite Element Formulation of the Unsteady Incompressible NavierStokes Equations Using SUPG and Linear Equalorder Element Methods
,”
Comput. Methods Appl. Mech. Eng.
0045-7825,
143
, pp.
333
348
.
26.
Cha
,
K. S.
,
Choi
,
J. W.
, and
Park
,
C. G.
, 2002, “
Finite Element Analysis of Fluid Flows With Moving Boundary
,”
KSME Int. J.
1226-4865,
16
, pp.
683
695
.
27.
Cha
,
K. S.
, 2004, “
Finite Element Analysis of Unsteady Separated Flows Around a Moving Body
,” Ph.D. thesis, Chonnam National University.
28.
Enzmann
,
D. R.
,
Ross
,
M. R.
,
Marks
,
M. P.
, and
Pelc
,
N. J.
, 1994, “
Blood Flow in Major Cerebral Arteries Measured by Phase Contrast Cine MR
,”
AJNR Am. J. Neuroradiol.
0195-6108,
15
, pp.
123
129
.
29.
Perktold
,
K.
,
Peter
,
R.
, and
Resch
,
M.
, 1989, “
Pulsatile Non-Newtonian Blood-Flow Simulation Through a Bifurcation With an Aneurysm
,”
Biorheology
0006-355X,
26
(
6
), pp.
1011
1030
.
30.
Valencia
,
A. A.
,
Guzman
,
A. M.
,
Finol
,
E. A.
, and
Amon
,
C. H.
, 2006, “
Blood Flow Dynamics in Saccular Aneurysm Models of the Basilar Artery
,”
ASME J. Biomech. Eng.
0148-0731,
128
(
4
), pp.
516
526
.
31.
Cha
,
K. S.
,
Balaras
,
E.
, and
Lieber
,
B. B.
, 2005, “
A Computational Study of the Role of Hemodynamics in Cerebral Aneurysm Coil Compaction
,”
Proceedings of the ASME 2005 Summer Bioengineering Conference
,
Vail, CO
, Jun. 22–26.
32.
Castro
,
E.
,
Fortea
,
F.
,
Villoria
,
F.
,
Lacruz
,
C.
,
Ferreras
,
B.
, and
Carrillo
,
R.
, 1999, “
Longterm Histopathologic Findings in Two Cerebral Aneurysms Embolized With Guglielmi Detachable Coils
,”
AJNR Am. J. Neuroradiol.
0195-6108,
20
, pp.
549
552
.
33.
Horowitz
,
M. B.
,
Purdy
,
P. D.
,
Burns
,
D.
, and
Bellotto
,
D.
, 1997, “
Scanning Electron Microscopic Findings in a Basilar Tip Aneurysm Embolized With Guglielmi Detachable Coils
,”
AJNR Am. J. Neuroradiol.
0195-6108,
18
, pp.
688
690
.
34.
Molyneux
,
A. J.
,
Ellison
,
D. W.
,
Morris
,
J.
, and
Byrne
,
J. V.
, 1995, “
Histological Findings in Giant Aneurysms Treated With Guglielmi Detachable Coils: Report of Two Cases With Autopsy Correlation
,”
J. Neurosurg.
0022-3085,
83
, pp.
129
132
.
35.
Sluzewski
,
M.
,
Menovsky
,
T.
,
van Rooij
,
W. J.
, and
Wijnalda
,
D.
, 2003, “
Coiling of Very Large or Giant Cerebral Aneurysms: Long-Term Clinical and Serial Angiographic Results
,”
AJNR Am. J. Neuroradiol.
0195-6108,
24
, pp.
257
262
.
36.
Murayama
,
Y.
,
Tateshima
,
S.
,
Gonzalez
,
N. R.
, and
Viuela
,
F.
, 2003, “
Matrix and Bioabsorbable Polymeric Coils Accelerate Healing of Intracranial Aneurysms: Long Term Experimental Study
,”
Rev. Odontol. St Catarina
,
34
(
8
), pp.
2031
2037
.
37.
Raymond
,
J.
,
Roy
,
D.
,
Leblanc
,
P.
,
Roorda
,
S.
,
Janicki
,
C.
,
Normandeau
,
L.
,
Morel
,
F.
,
Bahary
,
J. P.
,
Chagnon
,
M.
,
Guilbert
,
F.
, and
Weill
,
A.
, 2003, “
Endovascular Treatment of Intracranial Aneurysms With Radioactive Coils: Initial Clinical Experience
,”
Rev. Odontol. St Catarina
,
34
, pp.
2801
2806
.
38.
Abrahams
,
J. M.
,
Diamond
,
S. L.
,
Hurst
,
R. W.
,
Zager
,
E. L.
,
Grady
,
M. S.
, 2000, “
Topic Review: Surface Modifications Enhancing Biological Activity of Guglielmi Detachable Coils in Treating Intracranial Aneurysms
,”
Surg. Neurol.
0090-3019,
54
, pp.
34
40
.
39.
Tamatani
,
S.
,
Ito
,
Y.
,
Abe
,
H.
,
Koike
,
T.
,
Takeuchi
,
S.
, and
Tanaka
,
R.
, 2002, “
Evaluation of the Stability of Aneurysms Using Detachable Coils: Correlation Between Stability of Aneurysms and Embolized Volume of Aneurysms
,”
AJNR Am. J. Neuroradiol.
0195-6108,
23
, pp.
762
767
.
40.
Kawanabe
,
Y.
,
Sadato
,
A.
,
Taki
,
W.
, and
Hashimoto
,
N.
, 2001, “
Endovascular Occlusion of Intracranial Aneurysms With Guglielmi Detachable Coils: Correlation Between Coil Packing Density and Coil Compaction
,”
Acta Neurochir. Suppl. (Wien)
0065-1419,
143
, pp.
451
455
.
41.
Uchiyama
,
N.
,
Kida
,
S.
,
Nomura
,
M.
,
Hasegawa
,
M.
,
Yamashima
,
T.
,
Yamashita
,
J.
, and
Matsui
,
O.
, 2000, “
Significance of Volume Embolization Ratio as a Predictor of Recanalization on Endovascular Treatment of Cerebral Aneurysms With Guglielmi Detachable Coils
,”
Intervent. Neuroradiol.
,
6
, pp.
59
63
.
42.
Satoh
,
K.
,
Matsubara
,
S.
,
Hondoh
,
H.
, and
Nagahiro
,
S.
, 1997, “
Intracranial Aneurysm Embolization Using Interlocking Detachable Coils: Correlation Between Volume Embolization Rate and Coil Compaction
,”
Intervent. Neuroradiol.
,
3
, pp.
125
129
.
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