Permeability is one of the fundamental properties of porous media and is required for largescale Darcian fluid flow and mass transport models. Whilst permeability can be measured directly at a range of scales, there are increasing opportunities to evaluate permeability from pore-scale fluid flow simulations. We introduce the free software Finite-Difference Method Stokes Solver (FDMSS) that solves Stokes equation using a finite-difference method (FDM) directly on voxelized 3D pore geometries (i.e. without meshing). Based on explicit convergence studies, validation on sphere packings with analytically known permeabilities, and comparison against lattice-Boltzmann and
Over the past 15 years, coil embolization has emerged as an effective treatment option for cerebral aneurysms that is far less invasive than the long-standing convention of surgical clipping. However, aneurysm recurrence after coil embolization is not uncommon: recurrence rates as high as 50% have been reported in the literature. One factor that may contribute to recurrence after coiling is residual flow into the aneurysmal sac. At present, there is limited quantitative knowledge of the relationship between coil packing density and aneurysmal inflow. We present an in vitro fluid dynamic study of basilar tip aneurysm models that elucidates this relationship. At physiologically normal flow rates, we found that a packing density of 28.4% decreased aneurysmal inflow by 31.6% in a wide-neck model, and that a packing density of 36.5% decreased aneurysmal inflow by 49.6% in a narrow-neck model. Results also indicated that coiling reduced aneurysmal inflow more significantly at lower parent vessel flow rates, and that coiling reduced neck-plane velocity magnitudes more significantly for narrow-neck aneurysms. Our study provides novel quantitative information that could ultimately contribute to improved outcomes for patients with cerebral aneurysms by enabling more effective coil embolization.
Treatment options for cerebral aneurysms have drastically evolved in the last decade. In the past, surgical clipping through craniotomy was the predominant treatment option for cerebral aneurysms. Presently, endovascular coiling, a minimally invasive technique, has superseded clipping in many centers [1]. However, the coiling of wide-neck aneurysms is still a challenge [2]. Complete aneurysmal occlusion is often impossible [3]. Recently, stand-alone stents have been explored as an alternative treatment option for wide-neck aneurysms [4].
Although coil embolization is one of the most effective treatments for intracranial aneurysms (ICAs), the procedure is often unsuccessful. For example, an ICA may persist after coil embolization if deployed coils fail to block the flow of blood into the aneurysm. Unfortunately, the specific flow changes that are effected by embolic coiling (and other endovascular therapies) are poorly understood, which creates a barrier to the design and execution of optimal treatments in the clinic. We present an in vitro pulsatile flow study of treated basilar tip aneurysm models that elucidates relationships between controllable treatment parameters and clinically important post-treatment fluid dynamics. We also compare fluid dynamic performance across embolic coils and more recently proposed devices (e.g., the Pipeline Embolization Device) that focus on treating ICAs by diverting rather than blocking blood flow. In agreement with previous steady flow studies, coil embolization-reduced velocity magnitude at the aneurysmal neck by greater percentages for a narrow-neck aneurysm, and reduced flow into aneurysms by greater percentages at lower parent vessel flow rates. However, flow diversion reduced flow into a wide-neck aneurysm more so than coil embolization, regardless of flow conditions. Finally, results also showed that for the endovascular devices we examined, treatment effects were generally less dramatic under physiologic pulsatile flow conditions as compared to steady flow conditions. The fluid dynamic performance data presented in this study represent the first direct in vitro comparison of coils and flow diverters in aneurysm models, and provide a novel, quantitative basis to aid in designing endovascular treatments toward specific fluid dynamic outcomes.
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