中国组织工程研究

中国组织工程研究

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急性脑栓塞Penumbra机械取栓1例的有限元分析

刘  波1，谢  鹏2，李志伟1   

  1. 1重庆医科大学附属永川医院神经内科，重庆市 402160；2重庆医科大学附属第一医院神经内科，重庆市 400016
  • 收稿日期:2013-08-07 出版日期:2014-04-30 发布日期:2014-04-30
  • 通讯作者: 李志伟，主任医师，教授，重庆医科大学附属永川医院神经内科，重庆市 402160
  • 基金资助:

    重庆市永川区自然科学基金资助项目(Ycstc,2013nc8031)；重庆市卫生局资助项目（2010-2-250）；重庆市永川区软科学基金资助项目(Ycstc, 2011BE5004)

Finite Element Analysis of An Acute Cerebral Embolism Example of Mechanical Embolectomy Using Penumbra System

Liu Bo1, Xie Peng2, Li Zhi-wei1   

  1. 1Department of Neurology,YongChuan Hospital,Chongqing Medical University,Chongqing 402160,China；2Department of Neurology, The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China
  • Received:2013-08-07 Online:2014-04-30 Published:2014-04-30
  • Contact: Central Hospital of Xiangyang, Xiangyang 441g, Xiangyang 441021, Hubei Province, China liankai2000@163.com
  • Supported by:

    Natural Science Foundation of Yongchuan District of Chongqing City, No. Ycstc,2013nc8031; Foundation of Chongqing Municipal Health Bureau, No. 2010-2-250;Soft Science Foundation of Yongchuan District of Chongqing City, No. Ycstc, 2011BE5004

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摘要：

背景：脑栓塞是临床常见病，病死率高，使用Penumbra机械取栓被认为是一种全新的有效方法，但目前开展的病例较少，对该种手术对于局部脑血管的影响认识尚不清楚。

目的：通过数值模拟描述Penumbra机械取栓对1例脑栓塞患者局部脑血管的影响。
方法：选取左侧大脑中动脉急性栓塞患者1例，女，77岁。在急诊DSA术中对其各种原始数据进行采集，并使用Penumbra成功机械取栓。术后对其原始数据进行处理，建成“由近及远吸栓法”和“由远及近吸栓法”两种取栓方法的三维数值模型，并进行有限元分析。
结果与结论：成功地完成建模和有限元分析；结果提示：与“由近及远吸栓法”相比，“由远及近吸栓法”的模型有较小的吸栓导管内流速和血栓壁面切应力(P < 0.01)，有较大的血管壁壁面切应力、血管壁变形量(P < 0.01)和血栓变形量(P < 0.05)。结果可见Penumbra机械取栓的有限元分析有助于介入医师更加清楚认识自己的操作对患者脑血管的影响，作为一种研究方法值得今后继续探讨。

关键词: 脑栓塞, 号机械取栓术, 号脑血管造影, 号流固耦合模型, 号有限元分析

Abstract:

BACKGROUND: Cerebral embolism is a common disease with high mortality, mechanical thrombectomy using Penumbra system is considered to be a new and effective method. However, there were few cases currently, it is a unclear understanding of effects on regional cerebral blood vessels using this kind of surgery.

OBJECTIVE: Numerical simulation describes effects on regional cerebral blood vessels of an acute cerebral embolism patient by mechanical embolectomy using Penumbra system.
METHODS: A 77-year-old woman was selected suffering from the left middle cerebral artery embolization. Various raw data was collected in emergency cerebral angiography,then mechanical thrombectomy using Penumbra system was carried out successfully.After these raw data was processed into dimensional numerical models of two kinds of embolectomy methods ( " suction bolt method from near to far " and " suction bolt method from far to near " ), then finite element analysis was carried out.
RESULTS: Successfully complete modeling and finite element analysis . The results suggest that:compared with " suction bolt method from near to far ", " suction bolt method from far to near " models had smaller velocity of flow in catheter and smaller wall shear stress of thrombus (P <0.01), and had larger wall shear stress of blood vessel wall, deformation of blood vessel wall (P <0.01) and deformation of thrombus (P < 0.05).

CONCLUSIONS: Finite element analysis of mechanical embolectomy using Penumbra system can help physicians involved in a clearer understanding of their impact on cerebrovascular of patients. As a research method,It is worth to continue to explore in the future.

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