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Quantitative Effects of Coil Packing Density on Cerebral Aneurysm Fluid Dynamics: An In Vitro Steady Flow Study

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Abstract

Over the past 15 years, coil embolization has emerged as an effective treatment option for cerebral aneurysms that is far less invasive than the long-standing convention of surgical clipping. However, aneurysm recurrence after coil embolization is not uncommon: recurrence rates as high as 50% have been reported in the literature. One factor that may contribute to recurrence after coiling is residual flow into the aneurysmal sac. At present, there is limited quantitative knowledge of the relationship between coil packing density and aneurysmal inflow. We present an in vitro fluid dynamic study of basilar tip aneurysm models that elucidates this relationship. At physiologically normal flow rates, we found that a packing density of 28.4% decreased aneurysmal inflow by 31.6% in a wide-neck model, and that a packing density of 36.5% decreased aneurysmal inflow by 49.6% in a narrow-neck model. Results also indicated that coiling reduced aneurysmal inflow more significantly at lower parent vessel flow rates, and that coiling reduced neck-plane velocity magnitudes more significantly for narrow-neck aneurysms. Our study provides novel quantitative information that could ultimately contribute to improved outcomes for patients with cerebral aneurysms by enabling more effective coil embolization.

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Acknowledgments

The authors thank EV3 (Plymouth, MN, USA), and specifically Victoria Schuman, Ph.D., for their guidance and for the generous donation of embolic coils, balloons, and catheters that made this study possible. The authors also thank Hristo Nikolov, M.S. (Imaging Research Laboratories, Robarts Research Institute, University of Western Ontario, London, Canada), for his valuable contributions to our work.

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Authors and Affiliations

  1. School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler, ECG 334, P.O. Box 879709, Tempe, AZ, 85287-9709, USA

    M. Haithem Babiker & David H. Frakes

  2. Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA

    L. Fernando Gonzalez & Felipe Albuquerque

  3. Partnership for Research in Spatial Modeling, Arizona State University, Tempe, AZ, USA

    Daniel Collins & Arius Elvikis

  4. School of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, AZ, USA

    David H. Frakes

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  1. M. Haithem Babiker
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  2. L. Fernando Gonzalez
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  3. Felipe Albuquerque
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Correspondence to M. Haithem Babiker.

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Associate Editor Larry V. McIntire oversaw the review of this article.

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Babiker, M.H., Gonzalez, L.F., Albuquerque, F. et al. Quantitative Effects of Coil Packing Density on Cerebral Aneurysm Fluid Dynamics: An In Vitro Steady Flow Study. Ann Biomed Eng 38, 2293–2301 (2010). https://doi.org/10.1007/s10439-010-9995-4

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  • DOI: https://doi.org/10.1007/s10439-010-9995-4

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