A Virtual Coiling Technique for Image-Based Aneurysm Models by Dynamic Path Planning

Abstract

Computational algorithms modeling the insertion of endovascular devices, such as coil or stents, have gained an increasing interest in recent years. This scientific enthusiasm is due to the potential impact that these techniques have to support clinicians by understanding the intravascular hemodynamics and predicting treatment outcomes. In this work, a virtual coiling technique for treating image-based aneurysm models is proposed. A dynamic path planning was used to mimic the structure and distribution of coils inside aneurysm cavities, and to reach high packing densities, which is desirable by clinicians when treating with coils. Several tests were done to evaluate the performance on idealized and image-based aneurysm models. The proposed technique was validated using clinical information of real coiled aneurysms. The virtual coiling technique reproduces the macroscopic behavior of inserted coils and properly captures the densities, shapes and coil distributions inside aneurysm cavities. A practical application was performed by assessing the local hemodynamic after coiling using computational fluid dynamics (CFD). Wall shear stress and intra-aneurysmal velocities were reduced after coiling. Additionally, CFD simulations show that coils decrease the amount of contrast entering the aneurysm and increase its residence time.

Blood flow in the cerebral venous system: modeling and simulation

“…carotid arteries, basilar trunk, and the circle of Willis) are the focus of multiple investigations and references therein). In this context, blood flow computational models are relevant to various clinical applications, such as check-up and follow-up of aneurysms (Cebral et al (2005); Shojima et al (2014); Retarekar et al (2015)) and control after stenting (Wang et al (2011)) or coiling (Morales et al (2013)). In contrast, the behavior of the venous cerebral system is rarely explored.…”

Precision Imaging: more descriptive, predictive and integrative imaging

“…Combined with virtual interventions (e.g. Larrabide et al, 2012;Morales et al, 2013), this approach enables execution of in silico clinical trials (Viceconti et al, 2016) or supporting of regulatory processes (Center for Devices and Radiological Health, 2014) especially in scenarios that could be impractical, costly or unethical (e.g. Larrabide et al, 2013;Morales et al, 2011) to carry out in animals or humans as a first line of choice.…”

Guest Editorial Special Issue on Medical Imaging and Image Computing in Computational Physiology

“…The work by Morales et al [27] present a method based on dynamic path planning to model the distribution of embolization coils in cerebral aneurysms. The virtual coiling technique reproduces the macroscopic behavior of inserted coils and properly captures the densities, shapes and coil distributions inside aneurysmal cavities.…”

“…Modeling for Interventional Planning: The work by Morales et al [27] showed how the combination of device modeling and virtual deployment, in addition to patient-specific image-based anatomical modeling, can help to carry out patient-specific treatment plans and assess alternative therapeutic strategies. Although a number of such approaches have already been introduced in the literature [73]- [79], further research efforts will be invested in modeling devices and interventions as well as the interplay between the devices and relevant biological processes [80]- [84].…”