• Takumi Ishii, Soichiro Fujimura, Hiroyuki Takao, Yuya Uchiyama, Takuma Okudaira, Toshihiro Ishibashi, Katharina Otani, Kostadin Karagiozov, Koji Fukudome, Makoto Yamamoto, and Yuichi Murayama.
• Graduate School of Mechanical Engineering, Tokyo University of Science, Katsushika-ku, Tokyo, Japan; Department of Innovation for Medical Information Technology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
• World Neurosurg. 2021 Nov 1; 155: e95-e110.

ObjectiveCoil compaction is directly related to the degree of cerebral aneurysmal recanalization. The degree of recanalization (DoR) was quantified by measuring the volume vacated by coil deformation. The purpose of this study was to clarify the hemodynamic and morphologic factors associated with coil compaction.MethodsComputational fluid dynamics simulations were performed on 28 middle-size (5-10 mm) unruptured basilar artery tip aneurysms. The DoR was measured by comparing the coil mass shape obtained from three-dimensional digital subtraction angiography data immediately after coil embolization and again within 1-2 years of follow-up. Deployed coils were modeled using a virtual coiling technique for computational fluid dynamics simulations. Hemodynamic and morphologic factors to predict the DoR were derived using multiple linear regression.ResultsAneurysmal neck area, the maximum pressure generated on the neck surface after coil embolization, and the high-pressure position on the neck surface predicted DoR with statistic significance (P < 0.001, P < 0.001, P = 0.004, respectively). The DoR tended to increase when the neck area was large, the pressure generated on the coils was high, and the high-pressure position was close to the center of the neck surface. The volume embolization ratio was not statistically relevant for the DoR in the cases of this study.ConclusionsCoil compaction occurs in cerebral aneurysms with a wide neck, high pressure generated on the coils, and high pressure in the center of the neck surface. Establishing the DoR can contribute to the prediction of recanalization after coil embolization.Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.

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