In the last decade, preoperative modelling of the treatment of cerebral aneurysms is being actively developed. Fluid-structure interaction problem is a key point of a such modelling. Hence arises the question about the reasonable choice of the model of the vessel and aneurysm wall material to build the adequate model from the physical point of view. This study covers experimental investigation of 8 tissue samples of cerebral aneurysms and 1 tissue sample of a healthy cerebral artery. Results on statistical significance in ultimate stress for the classification of 2 cohorts of aneurysms: ruptured and unruptured described earlier in the literature were confirmed (p ≤ 0.01). We used the four most common models of hyperelastic material: Yeoh, Neo-Hookean and Mooney-Rivlin (3 and 5 parameter) models to describe the experimental data. In this study for the first time, we obtained a classification of hyperelastic models of cerebral aneurysm tissue, which allows to choose the most appropriate model for the simulation problems requirements depending on the physical interpretation of the considered problem: aneurysm status and range of deformation.
The study demonstrated superior clinical outcomes for endovascular flow diversion in comparison with bypass surgery in treatment of complex aneurysms. Though, both techniques grant similar percentage of major neurologic complications and comparable cure rate for cranial neuropathy. Nevertheless, flow diversion is associated with significantly lower early obliteration rate, thus possesses patient for risks of prolonged dual antiplatelet regimen and delayed rupture. Hence, it's important to stratify patient by the natural risk of aneurysm rupture prior to treatment selection.
In practical neurosurgery, an important issue is determining the status of the aneurysm and predicting its further growth, rupture or stabilization. The main approaches for the study of risk analysis asessment are computational hydrodynamics and analysis of the mechanics of the wall of cerebral aneurysm. In this paper, an analysis of various sections of the wall of cerebral aneurysm is given, combining mechanical test data and histological examination data. It was shown that, along with significant differences in mechanics, a different degree of calcification is observed in the tissue, which indicates a different level of impaired transport of substances inside the tissue.
Оперативное лечение дистальных аневризм экстракраниального отдела внутренней сонной артерии, сочетающихся с ее патологической извитостью К.м.н. в.Э. ГУжиН, а.в. ДУБовой, а.в. череПаНов ФГБУ «Федеральный центр нейрохирургии» минздрава россии, Новосибирск, россия аневризмы экстракраниального отдела внутренней сонной артерии (вса), расположенные у входа в череп, являются редкой патологией. При данной патологии показано проведение хирургического вмешательства из-за опасности артерио-артериальной эмболии с развитием нарушения мозгового кровообращения. в отечественной и зарубежной литературе представлены единичные случаи или небольшие по числу наблюдений группы успешного хирургического лечения пациен-тов с дистально расположенными аневризмами внутренней сонной артерии в сочетании с ее патологической извитостью. открытое оперативное вмешательство при этой локализации аневризмы является сложным из-за травматичности доступа. Проведение эндоваскулярных вмешательств не всегда возможно из-за наличия дегенеративных изменений сосудистой стенки и патологической извитости артерии. Предложен вариант хирургического вмешательства по созданию экстраана-томического высокопотокового шунта между наружной сонной артерией и м2 сегментом среднемозговой артерии. Пред-ставлены результаты успешного применения данной методики у 3 пациентов с дистально расположенными аневризмами экстракраниального отдела внутренней сонной артерии в сочетании с ее патологической извитостью.
Ключевые слова: патологическая извитость артерий, аневризма, внутренняя сонная артерия, высокопотоковый шунт.
Surgical treatment of distal extracranial internal carotid artery aneurysms associated with pathological artery kinkingv.E. Guzhin, a.v. DuBovoY, a.v. chErEPanov Federal center of neurosurgery, novosibirsk, russia Extracranial internal carotid artery (ica) aneurysms located at the entrance of the skull are a rare pathology. Surgical treatment is indicated for this pathology because of the risk of arterio-arterial embolism and the development of cerebrovascular disease. the domestic and international literature reports single cases or small group cases of successful surgical treatment of patients with distal internal carotid artery aneurysms associated with pathological kinking of the artery. open surgery for aneurysms of this localization is complicated because of a high injury risk associated with the approach. Endovascular interventions are not always possible due to the presence of degenerative changes in the vascular wall and pathological artery kinking. We propose a surgical option for creating a high-flow ec-ic bypass between the external carotid artery and the m2 segment of the middle cerebral artery. the article describes the results of successful application of this technique in three patients with distal extracranial internal carotid artery aneurysms associated with pathological kinking of the artery.
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