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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

WSS contour plots for aneurysmal and the vessel walls for both patients before and after stent implantation
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Related In: Results  -  Collection


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Fig9: WSS contour plots for aneurysmal and the vessel walls for both patients before and after stent implantation

Mentions: The trend and magnitude of the changes in WSS patterns on the aneurysmal wall and the vessel walls before and after stent treatment for both patients are similar to those in the idealized model (Fig. 9). At the distal neck of the aneurysm, the shear stress increases slightly for both patients, with peak WSSs going from 20.9 to 22.3 N m−2 for Patient 1 and from 19.9 to 20.6 N m−2 for Patient 2. The WSS in the side branch vessel is only slightly altered due to stenting, changing from 25.4 to 25.0 N m−2 for Patient 1 and from 4.0 to 3.9 N m−2 for Patient 2. The WSS in the side branch of Patient 2 is much smaller, since the other side branch (“B*” in Fig. 2) drains a portion of the influx away. This provides further evidence that the WSS on a small side branch would remain almost unchanged after stenting.Fig. 9


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)

WSS contour plots for aneurysmal and the vessel walls for both patients before and after stent implantation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig9: WSS contour plots for aneurysmal and the vessel walls for both patients before and after stent implantation
Mentions: The trend and magnitude of the changes in WSS patterns on the aneurysmal wall and the vessel walls before and after stent treatment for both patients are similar to those in the idealized model (Fig. 9). At the distal neck of the aneurysm, the shear stress increases slightly for both patients, with peak WSSs going from 20.9 to 22.3 N m−2 for Patient 1 and from 19.9 to 20.6 N m−2 for Patient 2. The WSS in the side branch vessel is only slightly altered due to stenting, changing from 25.4 to 25.0 N m−2 for Patient 1 and from 4.0 to 3.9 N m−2 for Patient 2. The WSS in the side branch of Patient 2 is much smaller, since the other side branch (“B*” in Fig. 2) drains a portion of the influx away. This provides further evidence that the WSS on a small side branch would remain almost unchanged after stenting.Fig. 9

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