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Background:  Using the finishing coils to densely pack the aneurysm neck is necessary. However, the exact hemodynamic effect of finishing coils in packing the aneurysm neck is unknown.   Objective:  To evaluate the hemodynamic characteristics of finishing coils to densely pack the aneurysm neck, using finite element method simulation.   Methods:  A computational study was performed based on a 44-year-old female patient with an unruptured wide-necked carotid-ophthalmic artery aneurysm treated with low-profile visualized intraluminal support stent-assisted coil embolization. Four computational fluid dynamics models including pre-treatment, post-stenting, common stent-assisted coil embolization (SACE), and common SACE with finishing coils were evaluated qualitatively and quantitatively.   Results:  Compared with the baseline of pretreatment model (100%), sac-averaged velocity in post-stenting, common SACE, and common SACE with finishing coil models decreased to 95.68%, 24.38%, and 13.20%, respectively; high flow volume (>0.1 m/s) around the aneurysm neck decreased to 92.19%, 9.59%, and 5.57%, respectively; and mean wall shear stress increased or decreased to 107%, 25.94%, and 23.89%, respectively.   Conclusion:  Finishing coils to densely pack the aneurysm neck can generate favorable hemodynamic modifications, which may decrease the recurrence.

Hemodynamic Effect of the Last Finishing Coils in Packing the Aneurysm Neck