3D Computational Fluid Dynamics of a Treated Vertebrobasilar Giant Aneurysm: A Multistage Analysis

Graziano, Francesca; Russo, Vittorio; Wang, W.; Khismatullin, Damir B.; Ulm, Arthur J.

doi:10.3174/ajnr.a3373

Cited by 12 publications

(5 citation statements)

References 48 publications

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“…VETMs can be used to pre‐operatively predict the likelihood of recanalization in candidate aneurysms for coil embolization. Presence of high WSS (>35 Pa as reported by Refs ) at the neck of the coiled aneurysms was shown to have a correlation with post‐treatment recanalization and regions of high WSS coincided with regions where recanalization happened …”

Section: Modeling Of Endovascular Devices and Their Deploymentsupporting

confidence: 61%

“…Presence of high WSS (>35 Pa as reported by Refs 155,156) at the neck of the coiled aneurysms was shown to have a correlation with post-treatment recanalization and regions of high WSS coincided with regions where recanalization happened. [155][156][157][158] Delayed or incomplete occlusion and posttreatment rupture are the challenging complications associated with flow diverter treatments. Currently, there is no reliable measure to predict the performance of implanted flow diverters in terms of inducing a durable clot that occludes the sac completely and triggers the process of healing.…”

Section: Modeling Of Endovascular Devices and Their Deploymentmentioning

confidence: 99%

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Virtual endovascular treatment of intracranial aneurysms: models and uncertainty

Sarrami‐Foroushani

Lassila

Frangi

2017

WIREs Mechanisms of Disease

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Virtual endovascular treatment models (VETMs) have been developed with the view to aid interventional neuroradiologists and neurosurgeons to pre-operatively analyze the comparative efficacy and safety of endovascular treatments for intracranial aneurysms. Based on the current state of VETMs in aneurysm rupture risk stratification and in patient-specific prediction of treatment outcomes, we argue there is a need to go beyond personalized biomechanical flow modeling assuming deterministic parameters and error-free measurements. The mechanobiological effects associated with blood clot formation are important factors in therapeutic decision making and models of post-treatment intra-aneurysmal biology and biochemistry should be linked to the purely hemodynamic models to improve the predictive power of current VETMs. The influence of model and parameter uncertainties associated to each component of a VETM is, where feasible, quantified via a random-effects meta-analysis of the literature. This allows estimating the pooled effect size of these uncertainties on aneurysmal wall shear stress. From such meta-analyses, two main sources of uncertainty emerge where research efforts have so far been limited: (1) vascular wall distensibility, and (2) intra/intersubject systemic flow variations. In the future, we suggest that current deterministic computational simulations need to be extended with strategies for uncertainty mitigation, uncertainty exploration, and sensitivity reduction techniques. WIREs Syst Biol Med 2017, 9:e1385. doi: 10.1002/wsbm.1385 For further resources related to this article, please visit the WIREs website.

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Section: Modeling Of Endovascular Devices and Their Deploymentsupporting

confidence: 61%

Section: Modeling Of Endovascular Devices and Their Deploymentmentioning

confidence: 99%

Virtual endovascular treatment of intracranial aneurysms: models and uncertainty

Sarrami‐Foroushani

Lassila

Frangi

2017

WIREs Mechanisms of Disease

View full text Add to dashboard Cite

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“…Additionally, they suggest that bleb formation can be the result of a high-WSS induced pathological pathway. Similarly, all available literature 10,[46][47][48][49] (in our knowledge) associate recanalization of the treated aneurysm with the occurrence of high-WSS patch at the neck. So for the present study, we treat an increase in WSS after foam insertion as a risk factor.…”

Section: Discussionmentioning

confidence: 68%

Assessment and visualization of hemodynamic loading in aneurysm sac and neck: Effect of foam insertion

Pandey

Paul

Das

et al. 2021

Proc Inst Mech Eng H

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Shape memory polymer (SMP) foam is often proposed as the future alternative of coils in aneurysm treatment devices. Present work numerically investigates the unsteady, three-dimensional simulation of blood flow in a cerebral aneurysm filled with SMP foam. Simulations are conducted on patient-specific geometries with realistic blood velocity waveform imposed at the inlet while SMP foam is treated as a porous medium. The present study introduces a “loading risk map” that helps to visualize the hemodynamic effect of foam insertion on the aneurysm sac and neck. The loading risk maps suggest that while the SMP foam subdues the flow and wall shear pulsations in the aneurysm sac, the pressure distribution is minimally affected. The maps suggest that while the downstream lip is the most risk-prone site for both geometries, downstream vascular anatomy significantly influences foam efficiency in reducing pressure and wall shear stress loading.

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“…These are typically the areas where focal fusiform dilatations occur in VBDAs. In a case report examining hemodynamic characteristics of a giant vertebrobasilar junction aneurysm, Graziano et al found high velocity of blood flow at the aneurysm neck with stagnant, low flow conditions in the central portion of the aneurysm 20. In another case report, Hassan et al reported CFD findings in a patient with a giant fusiform vertebrobasilar aneurysm and found complex intra-aneurysmal flow patterns with vortex type flow in an area of thrombosis 21.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic characteristics of stable and unstable vertebrobasilar dolichoectatic and fusiform aneurysms

Brinjikji¹,

Chung²,

Ding³

et al. 2018

J NeuroIntervent Surg

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3D Computational Fluid Dynamics of a Treated Vertebrobasilar Giant Aneurysm: A Multistage Analysis

Cited by 12 publications

References 48 publications

Virtual endovascular treatment of intracranial aneurysms: models and uncertainty

Virtual endovascular treatment of intracranial aneurysms: models and uncertainty

Assessment and visualization of hemodynamic loading in aneurysm sac and neck: Effect of foam insertion

Hemodynamic characteristics of stable and unstable vertebrobasilar dolichoectatic and fusiform aneurysms

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