Can the Windkessel Hypothesis Explain Delayed Intraparenchymal Haemorrhage After Flow Diversion? A Case Report and Model-Based Analysis of Possible Mechanisms
Alim P Mitha, Jonathan P Mynard, John A Storwick, Zaher I Shivji, John H Wong, William Morrish
Heart, Lung and Circulation | ELSEVIER SCIENCE INC | Published : 2015
BACKGROUND: Delayed ipsilateral intraparenchymal haemorrhage is a recently recognised complication after endovascular flow diversion for intracranial aneurysms. Although the mechanism of this phenomenon is not understood, one proposed explanation (the windkessel hypothesis) is that removal of aneurysmal compliance increases distal pulse pressure. METHODS: We present a case of delayed haemorrhage after placement of a Pipeline stent, discuss the proposed mechanisms, and describe a novel electrical analogue model that was used to evaluate the likely haemodynamic effect of stent placement. RESULTS: Model-based analysis suggests that stenting is not likely to produce a significant change in dista..View full abstract
Author JPM was supported by a CJ Martin Early Career Fellowship from the National Health and Medical Research Council of Australia.