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Fig 1.

Schematic diagram of porous media modeling for coil embolization.

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Fig 2.

Representative cerebral aneurysm in the basilar artery (A-B).

A, control computational fluid dynamics (CFD) model; B, porous media CFD. From left to right, segmentation of the neck plane (black) and intra-aneurysmal domain to define porous media (pink domain), streamline, inflow area (red), outflow area (blue), wall shear stress, and flow volume domain with a mean flow velocity > 1.0 cm/s (red domain) indicating residual flow volume (RFV) on the porous media CFD.

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Fig 3.

Representative cerebral aneurysms.

A, right internal carotid artery aneurysm with complete occlusion; B, anterior communicating artery aneurysm with residual neck; C, right middle cerebral artery aneurysm with residual aneurysm on follow-up angiogram. From left to right, pre-coiling angiograms, post-coiling immediate angiograms, follow-up angiograms, segmentation of porous medium (pink domain), streamline at the post-coil embolization under the porous media model, and residual flow volume (RFV) with a mean flow velocity > 1.0 cm/s (red domain). Aneurysm volume (A:B:C = 54.8:255.4:146.7 mm3), coil packing density (38.7:24.3:24.7%), and RFV (3.7:27.1:56.5 mm3), respectively.

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Table 1.

Characteristics of unruptured cerebral aneurysms treated by coil embolization.

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Table 2.

Comparison of hemodynamic parameters using computational fluid dynamics analyses.

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Table 3.

Univariate and multivariate logistic regression analyses of independent parameters with respect to recurrence after coiling.

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Table 4.

Receiver operating characteristic (ROC) curve analyses of coiled aneurysm recurrence.

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Table 5.

Comparison of hemodynamic parameters using computational fluid dynamics analyses on transient analysis.

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Fig 4.

Preoperative simulation of a right internal carotid artery aneurysm.

A, flow volume domain with a mean flow velocity > 1.0 cm/s (red domain) indicating residual flow volume (RFV) simulated by various coil packing densities. B, graph showing that the coil packing density must be >25% by RFV values in the preoperative simulation to prevent aneurysm recurrence.

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