In silico thrombectomy trials for acute ischemic stroke

Miller, Claire; Konduri, Praneeta; Bridio, Sara; Luraghi, Giulia; Terreros, Nerea Arrarte; Boodt, Nikki; Samuels, Noor; Matas, José Félix Rodríguez; Migliavacca, Francesco; Lingsma, Hester F.; Lugt, Aad van der; Roos, Yvo B.W.E.M.; Dippel, Diederik W.J.; Marquering, Henk A.; Majoie, Charles B. L. M.; Hoekstra, Alfons G.

doi:10.1016/j.cmpb.2022.107244

Cited by 5 publications

(6 citation statements)

References 37 publications

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“…This work proposed the use of the SSM approach for the generation of virtual populations of cerebrovascular anatomies, useful for the development of in silico trials for AIS treatments. In [8], the first proof-of-concept in silico stroke trial was implemented, based on a surrogate model of the thrombectomy procedure trained on a dataset of 94 high-fidelity thrombectomy simulations run in patient-specific vascular models. The methodology described in the present work would enable the creation of the desired number of virtual stroke patients for increasing the reliability of an in silico stroke trial.…”

Section: Discussionmentioning

confidence: 99%

“…High-fidelity in silico models of the thrombectomy procedure have been recently proposed in the literature [4][5][6][7]. The stent-retriever thrombectomy simulation developed in [4], used to replicate a patient-specific case, was integrated into a framework for running the first proof-of-concept in silico trial for stroke treatments [8]. The framework was validated by replicating a real clinical trial and then employed to compare treatment outcomes in different subpopulations and with different thrombectomy devices, demonstrating the potentiality of the in silico approach to support clinical stroke trials.…”

Section: Introductionmentioning

confidence: 99%

“…Due to the limited accessibility, consistency, and quality of clinical images, the generation of virtual cohorts of patients is helpful to run in silico clinical trials. When an in silico trial is based solely on data-driven models, the cohort of patients can be represented by a set of metadata [8]. Differently, if the in silico trial pipeline includes high-fidelity modeling (e.g., [15,16]), the cohort of patients requires the collection of 3D domains.…”

Section: Introductionmentioning

confidence: 99%

“…This will facilitate the development of in silico trial approaches, reducing the issues related to the availability of high-quality images of stroke patients and to privacy concerns when sharing patient data between hospitals and modelers. Moreover, the availability of large populations for in silico modeling is required in general when running in silico stroke trials, and in particular to train accurate and fast surrogate models like the one used in [8]. To this aim, first, (i) an SSM approach is used to generate cerebrovascular anatomies described by their centerlines and associated diameters, starting from a cohort of 88 real AIS patients.…”

Section: Introductionmentioning

confidence: 99%

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Generation of a Virtual Cohort of Patients for in Silico Trials of Acute Ischemic Stroke Treatments

Bridio,

Luraghi,

Ramella

et al. 2023

Applied Sciences

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The development of in silico trials based on high-fidelity simulations of clinical procedures requires the availability of large cohorts of three-dimensional (3D) patient-specific anatomy models, which are often hard to collect due to limited availability and/or accessibility and imaging quality. Statistical shape modeling (SSM) allows one to identify the main modes of shape variation and to generate new samples based on the variability observed in a training dataset. In this work, a method for the automatic 3D reconstruction of vascular anatomies based on SSM is used for the generation of a virtual cohort of cerebrovascular models suitable for computational simulations, useful for in silico stroke trials. Starting from 88 cerebrovascular anatomies segmented from stroke patients’ images, an SSM algorithm was developed to generate a virtual population of 100 vascular anatomies, defined by centerlines and diameters. An acceptance criterion was defined based on geometric parameters, resulting in the acceptance of 83 generated anatomies. The 3D reconstruction method was validated by reconstructing a cerebrovascular phantom lumen and comparing the result with an STL geometry obtained from a computed tomography scan. In conclusion, the final 3D models of the generated anatomies show that the proposed methodology can produce a reliable cohort of cerebral arteries.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Generation of a Virtual Cohort of Patients for in Silico Trials of Acute Ischemic Stroke Treatments

Bridio,

Luraghi,

Ramella

et al. 2023

Applied Sciences

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“…Mechanical properties of the thrombus are defined following experimental characterization of clots produced in vitro . Because of their high accuracy, these models are being used as fundamental building blocks for the development of in silico clinical trials ( 23 ). Recently, the authors included both a clot fragmentation model and external aspiration ( 24 ).…”

Section: Introductionmentioning

confidence: 99%

A multiscale computational framework to evaluate flow alterations during mechanical thrombectomy for treatment of ischaemic stroke

Benemerito

Mustafa

Wang

et al. 2023

Front. Cardiovasc. Med.

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The treatment of ischaemic stroke increasingly relies upon endovascular procedures known as mechanical thrombectomy (MT), which consists in capturing and removing the clot with a catheter-guided stent while at the same time applying external aspiration with the aim of reducing haemodynamic loads during retrieval. However, uniform consensus on procedural parameters such as the use of balloon guide catheters (BGC) to provide proximal flow control, or the position of the aspiration catheter is still lacking. Ultimately the decision is left to the clinician performing the operation, and it is difficult to predict how these treatment options might influence clinical outcome. In this study we present a multiscale computational framework to simulate MT procedures. The developed framework can provide quantitative assessment of clinically relevant quantities such as flow in the retrieval path and can be used to find the optimal procedural parameters that are most likely to result in a favorable clinical outcome. The results show the advantage of using BGC during MT and indicate small differences between positioning the aspiration catheter in proximal or distal locations. The framework has significant potential for future expansions and applications to other surgical treatments.

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Towards a Generation of Digital Twins in Healthcare of Ischaemic and Haemorrhagic Stroke

Hoekstra,

Marquering

2024

Lecture Notes in Computer Science

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In silico thrombectomy trials for acute ischemic stroke

Cited by 5 publications

References 37 publications

Generation of a Virtual Cohort of Patients for in Silico Trials of Acute Ischemic Stroke Treatments

Generation of a Virtual Cohort of Patients for in Silico Trials of Acute Ischemic Stroke Treatments

A multiscale computational framework to evaluate flow alterations during mechanical thrombectomy for treatment of ischaemic stroke

Towards a Generation of Digital Twins in Healthcare of Ischaemic and Haemorrhagic Stroke

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