Computational Fluid Dynamics in Intracranial Atherosclerosis - Lessons from Cardiology: A Review of CFD in Intracranial Atherosclerosis

Pavlin-Premrl, Davor; Boopathy, Sethu; Nemes, András; Mohammadzadeh, Milad; Monajemi, Sadaf; Ko, Brian; Campbell, Bruce C.V.

doi:10.1016/j.jstrokecerebrovasdis.2021.106009

Cited by 12 publications

(10 citation statements)

References 35 publications

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“…7,9 Recently, the use of computational fluid dynamics, which has long been used in cardiology, gained some attention in evaluating the hemodynamics in ICAS lesions. 42 Using computed tomography angiography data to provide anatomic and functional data about ICAS, computational fluid dynamics data could be created by solving fluid dynamic equations. 43 The use of computational fluid dynamics has shown promise in identifying hemodynamically unstable ICAS lesions that could benefit from early intervention.…”

Section: Hypoperfusion-hemodynamic Failurementioning

confidence: 99%

Emergent Large Vessel Occlusion due to Intracranial Stenosis: Identification, Management, Challenges, and Future Directions

Al Kasab,

Nguyen,

Derdeyn

et al. 2024

Stroke

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This comprehensive literature review focuses on acute stroke related to intracranial atherosclerotic stenosis (ICAS), with an emphasis on ICAS-large vessel occlusion. ICAS is the leading cause of stroke globally, with high recurrence risk, especially in Asian, Black, and Hispanic populations. Various risk factors, including hypertension, diabetes, hyperlipidemia, smoking, and advanced age lead to ICAS, which in turn results in stroke through different mechanisms. Recurrent stroke risk in patients with ICAS with hemodynamic failure is particularly high, even with aggressive medical management. Developments in advanced imaging have improved our understanding of ICAS and ability to identify high-risk patients who could benefit from intervention. Herein, we focus on current management strategies for ICAS-large vessel occlusion discussed, including the use of perfusion imaging, endovascular therapy, and stenting. In addition, we focus on strategies that aim at identifying subjects at higher risk for early recurrent risk who could benefit from early endovascular intervention The review underscores the need for further research to optimize ICAS-large vessel occlusion treatment strategies, a traditionally understudied topic.

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Section: Hypoperfusion-hemodynamic Failurementioning

confidence: 99%

Emergent Large Vessel Occlusion due to Intracranial Stenosis: Identification, Management, Challenges, and Future Directions

Al Kasab,

Nguyen,

Derdeyn

et al. 2024

Stroke

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“…We searched PubMed from January 1995 to July 2021 and used the following search terms “intracranial stenosis” OR “intracranial atherosclerosis,” AND “transcranial Doppler” (TCD) or “magnetic resonance angiography” (MRA) or “CT angiography” (CTA) or “perfusion.” Once identified, the references were narrowed to investigations most applicable to the topic based on review of the abstracts. We supplemented this search by also including studies referenced review papers and meta-analyses on the novel imaging techniques, 12 –14 as well as commonly cited seminal clinical trials in the field. Additional studies were added per authors’ recommendations.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…Once identified, the references were narrowed to investigations most applicable to the topic based on review of the abstracts. We supplemented this search by also including studies referenced review papers and meta-analyses on the novel imaging techniques, [12][13][14] as well as commonly cited seminal clinical trials in the field. Additional studies were added per authors' recommendations.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

Intracranial atherosclerosis: Review of imaging features and advances in diagnostics

Kim

Schneider

Feldmann

et al. 2022

International Journal of Stroke

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Intracranial atherosclerotic disease is one of the leading causes of ischemic strokes and poses a moderate risk of recurrence. Diagnosis is currently limited to stenosis on luminal imaging, which likely underestimates the true prevalence of the disease. Detection of non-stenosing intracranial atherosclerosis is important in order to optimize secondary stroke prevention strategies. This review collates findings from the early seminal trials and the latest studies in advanced radiological techniques that characterize symptomatic intracranial atherosclerotic disease across various imaging modalities. While computed tomography angiography (CTA) and magnetic resonance angiography (MRA) comprise diagnostic mainstays in identifying stenotic changes secondary to atherosclerosis, emerging techniques such as high-resolution MRA, quantitative MRA, and computational fluid dynamics may reveal a myriad of other underlying pathophysiological mechanisms.

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“…Concerning medical and clinical research, the investigation of a human heart using cutting edge technologies is essential for understanding how the heart operates and for developing new treatments, therapies and surgical strategies for heartrelated conditions. More specifically, in recent years, researchers and clinicians utilized advanced imaging techniques to study the heart's anatomy and function [1] and computational simulations to study the hemodynamics of blood flow through the heart [2]. Moreover, Artificial Intelligence (AI) algorithms are applied to analyze large amounts of patient data making more accurate predictions of disease progression, treatment outcomes, and complications [3] and finally, Additive Manufacturing (AM) procedures are employed to construct identical models of human hearts [4].…”

Section: Introductionmentioning

confidence: 99%

Examination of a Human Heart utilizing Virtual Reality, Additive Manufacturing and Computational Technologies

Charalampous

Kladovasilakis

Zoumaki

et al. 2023

Preprint

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Purpose In this paper, an innovative approach concerning the investigation of the human heart is introduced employing state-of-the-art technologies. The presented technological tools aim in the creation of an innovative digital environment, where gaining surgical experience and developing pre-operative strategies could be achieved without the risk and anxiety of an actual heart surgery. Methods Sophisticated algorithms were developed in order to automatically reconstruct a 3D model of a human heart based on DICOM data and to segment the main parts that constitutes it. Taking into account the reconstructed 3D model, a diagnosis of the examined patient can be derived, where in the present study a Coarctation of the Aorta (CoA) clinical case was inspected. In addition, numerical approaches were considered that are able to simulate flows on complex shapes. Finally, a physical model was 3D printed via the MultiJet 3D Printing (MJP) process utilizing flexible materials. Results The outcomes of the computation analysis coupled with the automatically reconstructed and segmented patient-specific 3D model are inserted in a Virtual Reality (VR) environment, where the clinicians can visualize the blood flow at the vessel walls and train on real-life medical scenarios, enhancing that way the procedural understanding prior to the actual operation. Moreover, the 3D printed heart possesses an adequate mechanical response replicating the mechanical properties as well as the geometrical characteristics of the investigated human heart. Conclusions The present study introduced a robust software module for inspecting human hearts, aiding that way the medical doctors on the optimal preoperative assessment of patients with heart diseases using as input only the DICOM data of the examined patient.

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Computational Fluid Dynamics in Intracranial Atherosclerosis - Lessons from Cardiology: A Review of CFD in Intracranial Atherosclerosis

Cited by 12 publications

References 35 publications

Emergent Large Vessel Occlusion due to Intracranial Stenosis: Identification, Management, Challenges, and Future Directions

Emergent Large Vessel Occlusion due to Intracranial Stenosis: Identification, Management, Challenges, and Future Directions

Intracranial atherosclerosis: Review of imaging features and advances in diagnostics

Examination of a Human Heart utilizing Virtual Reality, Additive Manufacturing and Computational Technologies

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