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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

Computational results generated for pre-operation and post-operation models. a Streamline plots at peak systole for various side branch diameters are shown. When side branch diameter is small (d = 1.0 mm), flow velocity reduction in aneurysm sac after stenting is significant (see also Fig. 5). b 3D perspective vector diagrams near aneurysm neck of model with d = 1.0 mm
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Fig4: Computational results generated for pre-operation and post-operation models. a Streamline plots at peak systole for various side branch diameters are shown. When side branch diameter is small (d = 1.0 mm), flow velocity reduction in aneurysm sac after stenting is significant (see also Fig. 5). b 3D perspective vector diagrams near aneurysm neck of model with d = 1.0 mm

Mentions: The flow patterns before and after stent placement are shown in Fig. 4a. Before the placement of the stent, flow impingement onto the aneurismal wall can be observed near the distal neck. The flow then leaves the aneurysm sac via the proximal neck. After stent deployment, blood enters the aneurysm near the proximal neck through the pores and leaves the sac near the distal neck. The flow speed near the apex is reduced after stenting. The 3D vector diagrams clearly indicate the change in flow patterns near the neck due to the deployment of the flow-diverting stent (Fig. 4b), which compare favorably with the experimental results in the literature [23].Fig. 4


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)

Computational results generated for pre-operation and post-operation models. a Streamline plots at peak systole for various side branch diameters are shown. When side branch diameter is small (d = 1.0 mm), flow velocity reduction in aneurysm sac after stenting is significant (see also Fig. 5). b 3D perspective vector diagrams near aneurysm neck of model with d = 1.0 mm
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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Fig4: Computational results generated for pre-operation and post-operation models. a Streamline plots at peak systole for various side branch diameters are shown. When side branch diameter is small (d = 1.0 mm), flow velocity reduction in aneurysm sac after stenting is significant (see also Fig. 5). b 3D perspective vector diagrams near aneurysm neck of model with d = 1.0 mm
Mentions: The flow patterns before and after stent placement are shown in Fig. 4a. Before the placement of the stent, flow impingement onto the aneurismal wall can be observed near the distal neck. The flow then leaves the aneurysm sac via the proximal neck. After stent deployment, blood enters the aneurysm near the proximal neck through the pores and leaves the sac near the distal neck. The flow speed near the apex is reduced after stenting. The 3D vector diagrams clearly indicate the change in flow patterns near the neck due to the deployment of the flow-diverting stent (Fig. 4b), which compare favorably with the experimental results in the literature [23].Fig. 4

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