Computational Fluid Dynamics to Evaluate the Management of a Giant Internal Carotid Artery Aneurysm

Russin, Jonathan J.; Babiker, Haithem; Ryan, Justin; Rangel-Castilla, Leonardo; Frakes, David; Nakaji, Peter

doi:10.1016/j.wneu.2014.12.038

Cited by 22 publications

(11 citation statements)

References 17 publications

(19 reference statements)

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“…Currently, most fluid dynamic simulations use a fixed input function test, rather than patient-specific data for generation of the hemodynamic maps. 6,13–15…”

Section: Discussionmentioning

confidence: 99%

“…While there has been a body of literature in predicting flow changes post-treatment of intracranial aneurysms, most studies have concentrated on the hemodynamic changes only within the aneurysm itself. [5][6][7] Flow within the parent vessel and distal arterial tree before and after aneurysm treatment are much less understood, and have the potential to guide aneurysm treatment and postoperative care.…”

Section: Discussionmentioning

confidence: 99%

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Aneurysm size and the Windkessel effect: An analysis of contrast intensity in digital subtraction angiography

et al. 2017

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Large cerebral aneurysms are considered more dangerous than their smaller counterparts, with higher risk of subarachnoid hemorrhage. Understanding the hemodynamics of large aneurysms has potential to predict their response to treatment. Digital subtraction angiography images for patients with intracranial aneurysms over a seven-year period were reviewed. Unruptured solitary aneurysms of the internal carotid artery (ICA) proximal to the terminus and posterior communicating artery were included. Contrast intensity over time was analyzed at the center of the M1 segment of the middle cerebral artery distal to the aneurysm and compared to the contralateral side. Analysis included time to peak (TP)10%–100% (time needed for contrast to change from 10% intensity to 100%), washout time (WT)100%–10% (time for 100% intensity to 10%), and quartile time (QT)25%–25% (time for 25% intensity during vessel filling to 25% during emptying). Fifty patients met the inclusion criteria. Analysis over the ipsilateral M1 segment revealed a significant increase in QT25%–25% (8.5 vs 7.6 seconds, p = 0.006) compared to the contralateral side. There was a correlation between TP10%–100% and QT25%–25% with aneurysm size (Pearson’s r = 0.37, p = 0.007 and r = 0.43, p = 0.001, respectively). Larger ICA aneurysms were associated with delayed contrast intensity times . A plausible mechanism is that large aneurysms act as a capacitance chamber (Windkessel effect) that slow the arrival of contrast distal to the aneurysm. This may be of significance for large aneurysms after treatment, where the loss of the Windkessel effect places the distal circulation at greater risk for hemorrhage, and warrants further study.

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“…Currently, most fluid dynamic simulations use a fixed input function test, rather than patient-specific data for generation of the hemodynamic maps. 6,13–15…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Aneurysm size and the Windkessel effect: An analysis of contrast intensity in digital subtraction angiography

et al. 2017

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“…A mixed reality ventriculostomy simulator demonstrated both response processes and relations to other variables with a rating of 2 as an algorithm for timing and grading was used, and a difference between interns and residents was demonstrated, as well as a LoE of 1 33 . A cost effective 3D model for cerebral lateral ventriculostomy training was evaluated by 10 medical students and residents, demonstrating a LoE of 1, with no validity investigated 34 .…”

Section: Ventriculostomymentioning

confidence: 99%

A Systematic Review of Simulation-Based Training in Neurosurgery, Part 1: Cranial Neurosurgery

Patel

Aydın

Cearns³

et al. 2020

World Neurosurgery

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“…The proper selection of BCs in hemodynamics simulations is essential to obtain physiologically significance results. In literature, both steady and pulsatile volumetric flow rates were usually defined as inlet BC [47]. Although the steady-state simulations were regarded as a quick alternative to transient simulations in the previous study [24,48], their incapability of providing temporal hemodynamic parameters limited their applications.…”

Section: Modeling Considerationsmentioning

confidence: 99%

Impacts of Internal Carotid Artery Revascularization on Flow in Anterior Communicating Artery Aneurysm: A Preliminary Multiscale Numerical Investigation

Zhu

Wei

et al. 2019

Applied Sciences

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The optimal management strategy of patients with concomitant anterior communicating artery aneurysm (ACoAA) and internal carotid artery (ICA) stenosis is unclear. This study aims to evaluate the impacts of unilateral ICA revascularization on hemodynamics factors associated with rupture in an ACoAA. In the present study, a multiscale computational model of ACoAA was developed by coupling zero-dimensional (0D) models of the cerebral vascular system with a three-dimensional (3D) patient-specific ACoAA model. Distributions of flow patterns, wall shear stress (WSS), relative residence time (RRT) and oscillating shear index (OSI) in the ACoAA under left ICA revascularization procedure were quantitatively assessed by using transient computational fluid dynamics (CFD) simulations. Our results showed that the revascularization procedures significantly changed the hemodynamic environments in the ACoAA. The flow disturbance in the ACoAA was enhanced by the resumed flow from the affected side. In addition, higher OSI (0.057 vs. 0.02), prolonged RRT (1.14 vs. 0.39) and larger low WSS area (66 vs. 50 mm2) in ACoAA were found in the non-stenotic case. These acute changes in hemodynamics after revascularization may elevate the rupture risk of ACoAA. The preliminary results validated the feasibility of predicting aneurismal hemodynamics characteristics in revascularization procedures by using multiscale CFD simulations, which would benefit the management of this group of patients.

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Computational Fluid Dynamics to Evaluate the Management of a Giant Internal Carotid Artery Aneurysm

Cited by 22 publications

References 17 publications

Aneurysm size and the Windkessel effect: An analysis of contrast intensity in digital subtraction angiography

Aneurysm size and the Windkessel effect: An analysis of contrast intensity in digital subtraction angiography

A Systematic Review of Simulation-Based Training in Neurosurgery, Part 1: Cranial Neurosurgery

Impacts of Internal Carotid Artery Revascularization on Flow in Anterior Communicating Artery Aneurysm: A Preliminary Multiscale Numerical Investigation

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