Accepted Manuscript Hemodynamic Effect of Flow Diverter and Coils in the Treatment of Large and Giant Intracranial Aneurysms Linkai Jing, MS, Jingru Zhong, MS, Jian Liu, MD, Xinjian Yang, MD, PhD, Nikhil Paliwal, MD, Hui Meng, MD, PhD, Shengzhang Wang, MD, PhD, Ying Zhang, MD PII:

S1878-8750(16)00167-4

DOI:

10.1016/j.wneu.2016.01.079

Reference:

WNEU 3683

To appear in:

World Neurosurgery

Received Date: 15 September 2015 Revised Date:

27 January 2016

Accepted Date: 27 January 2016

Please cite this article as: Jing L, Zhong J, Liu J, Yang X, Paliwal N, Meng H, Wang S, Zhang Y, Hemodynamic Effect of Flow Diverter and Coils in the Treatment of Large and Giant Intracranial Aneurysms, World Neurosurgery (2016), doi: 10.1016/j.wneu.2016.01.079. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT Title page Title: Hemodynamic Effect of Flow Diverter and Coils in the Treatment of Large and Giant Intracranial Aneurysms Co-authors: Linkai Jing1, MS; Jingru Zhong2, MS; Jian Liu1, MD; Xinjian Yang1, MD, PhD; Paliwal Nikhil3,4, MD; Hui Meng4-7, MD, PhD; Shengzhang Wang8, MD,

E-mails:

[email protected],

[email protected],

RI PT

PhD; and Ying Zhang1, MD.

[email protected],

[email protected],

[email protected],

[email protected],

[email protected], [email protected]

SC

Affiliations: 1Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; 2Department of Biomedical Engineering, Capital

Engineering,

4

Department of Mechanical & Aerospace

Toshiba Stroke and Vascular Research Center, 6

Neurosurgery, 7

3

M AN U

Medical University, Beijing, China;

5

Department of

Department of Mechanical and Aerospace Engineering, and

Department of Biomedical Engineering, University at Buffalo, The State University

of New York, Buffalo, New York; 8Department of Mechanics and Engineering

TE D

Science, Fudan University, Shanghai, China.

Key words: Aneurysm, Flow diverter, Coil, Computational fluid dynamics, Hemodynamics

Abbreviation list: CFD = computational fluid dynamics; DSA = digital subtraction

EP

angiographic; FD = flow diverter; ICA = internal carotid artery; LSA= low wall shear area; WSS = wall shear stress.

AC C

Corresponding authors: Ying

Zhang,

MD,

Department

of

Interventional

Neuroradiology,

Beijing

Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, TiantanXili

6,

Dongcheng

Distict,

Beijing,

China,

100050.

Email:

[email protected]. Tel: +8610-67098852. Fax: +8610-67018349.

Shengzhang Wang, MD, PhD, Department of Mechanics and Engineering Science, Fudan University, 220 Handan Rd., Yangpu District, Shanghai, China, 200433. Email: [email protected]. Tel: +8621-65642737. Fax: +8621-65642737. 0

ACCEPTED MANUSCRIPT Abstract Background This study aimed to investigate the hemodynamic changes induced by the flow diverter (FD) and coils in treatment of internal carotid artery aneurysms, and to evaluate the effect of this treatment by using angiographic follow-up data.

RI PT

Methods Six large and giant aneurysms were treated by the Tubridge FD and loose packing coils between June 2013 and May 2015. Patient-specific models were constructed and analyzed by a computational fluid dynamics (CFD) method. The virtual FD deployment method was used to implant the Tubridge stent into a

SC

3D-digital subtraction angiographic image of the aneurysms and the coils were simulated by a porous medium model.

M AN U

Results Tubridge FD alone can significantly reduce the intra-aneurysmal flow velocity (0.17±0.05 to 0.11±0.06 m/s, P