Brain strokes comprise the third leading cause of death worldwide. Microsurgical clipping is recognized as being one of the most effective approaches to the treatment of brain aneurysms. The incomplete closure of the distal-side aneurysm neck is the most common cause of the persistent filling of the dome. Since the diameter of the neck increases when the neck of the aneurysm is squeezed closed by the blades of the clip, the blades should be correspondingly longer. This study provided an assessment of whether the presurgical selection of clips using a 3D planning system is feasible in terms of selecting the most suitable clip for aneurysm occlusion. The computational model was created based on computer tomography data obtained from nine brain aneurysms. The closing of the aneurysm was provided in two steps. The first the length of the blades used for closing corresponded to the length of the aneurysm neck as confirmed by the radiological measurements. The second the length of the blades was adjusted according to stage one, so as to determine the minimum required for the closure of all the gaps in the interior space of the aneurysm neck. No differences were detected between the radiological measurement of the aneurysm neck size and the measurements obtained from the reconstructed stereolithographic 3D models. It was observed that the size of the aneurysm neck increased following clipping by 40% to 60% of its original size. The larger the aneurysm neck, the greater the deformation of the aneurysm. Firstly, the 3D reconstruction of CT/MRI data did not result in any loss of accuracy and the measurement of the neck of the aneurysm was the same for both of the methods employed. The second, and more important, outcome was that the deformation of the neck of the cerebral aneurysm is at least 1.4x greater than its original size. This information is essential in terms of the pre-selection of the size of the clip.

中文翻译：

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脑动脉瘤显微手术夹闭的预选刀片尺寸选择：数值研究

脑中风是全球第三大死亡原因。显微外科夹闭术被认为是治疗脑动脉瘤最有效的方法之一。远端动脉瘤颈的不完全闭合是穹窿持续充盈的最常见原因。由于当动脉瘤颈部被夹子的刀片挤压闭合时颈部的直径增加，因此刀片应该相应地更长。这项研究评估了使用 3D 规划系统术前选择夹子在选择最适合动脉瘤闭塞的夹子方面是否可行。该计算模型是根据从九个脑动脉瘤获得的计算机断层扫描数据创建的。动脉瘤的闭合分两个步骤进行。首先，用于闭合的刀片的长度与放射学测量证实的动脉瘤颈部的长度相对应。第二，根据第一阶段调整刀片的长度，以确定关闭动脉瘤颈部内部空间中的所有间隙所需的最小值。动脉瘤颈尺寸的放射学测量与从重建的立体光刻 3D 模型获得的测量结果之间没有检测到差异。据观察，动脉瘤颈的尺寸在夹闭后增加了其原始尺寸的 40% 至 60%。动脉瘤颈越大，动脉瘤变形越大。首先，CT/MRI 数据的 3D 重建不会导致任何准确性损失，并且两种方法对动脉瘤颈部的测量是相同的。第二个也是更重要的结果是，脑动脉瘤颈的变形至少比原始尺寸大 1.4 倍。该信息对于预先选择剪辑的大小至关重要。