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Computational Fluid Dynamics Study of Bifurcation Aneurysms Treated with Pipeline Embolization Device: Side Branch Diameter Study.

Tang AY, Chung WC, Liu ET, Qu JQ, Tsang AC, Leung GK, Leung KM, Yu AC, Chow KW - J Med Biol Eng (2015)

Bottom Line: This may result in side-branch hypoperfusion subsequent to stenting.Furthermore, the peripheral resistance of downstream vessels is investigated by varying the outlet pressure conditions.This quantitative analysis can assist in treatment planning and therapeutic decision-making.

View Article: PubMed Central - PubMed

Affiliation: Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong, 999077 China.

ABSTRACT

An intracranial aneurysm, abnormal swelling of the cerebral artery, may lead to undesirable rates of mortality and morbidity upon rupture. Endovascular treatment involves the deployment of a flow-diverting stent that covers the aneurysm orifice, thereby reducing the blood flow into the aneurysm and mitigating the risk of rupture. In this study, computational fluid dynamics analysis is performed on a bifurcation model to investigate the change in hemodynamics with various side branch diameters. The condition after the deployment of a pipeline embolization device is also simulated. Hemodynamic factors such as flow velocity, pressure, and wall shear stress are studied. Aneurysms with a larger side branch vessel might have greater risk after treatment in terms of hemodynamics. Although a stent could lead to flow reduction entering the aneurysm, it would drastically alter the flow rate inside the side branch vessel. This may result in side-branch hypoperfusion subsequent to stenting. In addition, two patient-specific bifurcation aneurysms are tested, and the results show good agreement with the idealized models. Furthermore, the peripheral resistance of downstream vessels is investigated by varying the outlet pressure conditions. This quantitative analysis can assist in treatment planning and therapeutic decision-making.

No MeSH data available.


Related in: MedlinePlus

Patient-specific models utilized with aneurysm located near arterial bifurcation. Nearby geometries of two patient-specific models are close to those in idealized models
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Fig2: Patient-specific models utilized with aneurysm located near arterial bifurcation. Nearby geometries of two patient-specific models are close to those in idealized models

Mentions: The results from these idealized models are later compared with patient-specific configurations. Two aneurysms located near the bifurcation of the internal carotid artery (ICA) were selected, where the linear dimensions of the vessels in the nearby vasculature are close to those from the idealized models (Fig. 2). Patient 1 (male; age: 58 years) had a wide-necked aneurysm and Patient 2 (female; age: 75 years) had a saccular aneurysm. Both patients had undergone the pipeline stent treatment. The three-dimensional (3D) computational models were reconstructed from the angiograms using the software Mimics (Materialise, Leuven, Belgium) for CFD analysis. With the computer-aided design software SOLIDWORKS, the virtual stent was deployed in both models. The proximal parent artery and the side branch vessels that originate at the bifurcation and the distal parent vessel are denoted as “A”, “B”, and “C”, respectively, for both patients. For Patient 2, there is another side branch vessel upstream of the aneurysm (denoted as “B*” in Fig. 2).Fig. 2


Computational Fluid Dynamics Study of Bifurcation Aneurysms Treated with Pipeline Embolization Device: Side Branch Diameter Study.

Tang AY, Chung WC, Liu ET, Qu JQ, Tsang AC, Leung GK, Leung KM, Yu AC, Chow KW - J Med Biol Eng (2015)

Patient-specific models utilized with aneurysm located near arterial bifurcation. Nearby geometries of two patient-specific models are close to those in idealized models
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4491114&req=5

Fig2: Patient-specific models utilized with aneurysm located near arterial bifurcation. Nearby geometries of two patient-specific models are close to those in idealized models
Mentions: The results from these idealized models are later compared with patient-specific configurations. Two aneurysms located near the bifurcation of the internal carotid artery (ICA) were selected, where the linear dimensions of the vessels in the nearby vasculature are close to those from the idealized models (Fig. 2). Patient 1 (male; age: 58 years) had a wide-necked aneurysm and Patient 2 (female; age: 75 years) had a saccular aneurysm. Both patients had undergone the pipeline stent treatment. The three-dimensional (3D) computational models were reconstructed from the angiograms using the software Mimics (Materialise, Leuven, Belgium) for CFD analysis. With the computer-aided design software SOLIDWORKS, the virtual stent was deployed in both models. The proximal parent artery and the side branch vessels that originate at the bifurcation and the distal parent vessel are denoted as “A”, “B”, and “C”, respectively, for both patients. For Patient 2, there is another side branch vessel upstream of the aneurysm (denoted as “B*” in Fig. 2).Fig. 2

Bottom Line: This may result in side-branch hypoperfusion subsequent to stenting.Furthermore, the peripheral resistance of downstream vessels is investigated by varying the outlet pressure conditions.This quantitative analysis can assist in treatment planning and therapeutic decision-making.

View Article: PubMed Central - PubMed

Affiliation: Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong, 999077 China.

ABSTRACT

An intracranial aneurysm, abnormal swelling of the cerebral artery, may lead to undesirable rates of mortality and morbidity upon rupture. Endovascular treatment involves the deployment of a flow-diverting stent that covers the aneurysm orifice, thereby reducing the blood flow into the aneurysm and mitigating the risk of rupture. In this study, computational fluid dynamics analysis is performed on a bifurcation model to investigate the change in hemodynamics with various side branch diameters. The condition after the deployment of a pipeline embolization device is also simulated. Hemodynamic factors such as flow velocity, pressure, and wall shear stress are studied. Aneurysms with a larger side branch vessel might have greater risk after treatment in terms of hemodynamics. Although a stent could lead to flow reduction entering the aneurysm, it would drastically alter the flow rate inside the side branch vessel. This may result in side-branch hypoperfusion subsequent to stenting. In addition, two patient-specific bifurcation aneurysms are tested, and the results show good agreement with the idealized models. Furthermore, the peripheral resistance of downstream vessels is investigated by varying the outlet pressure conditions. This quantitative analysis can assist in treatment planning and therapeutic decision-making.

No MeSH data available.


Related in: MedlinePlus