Influence of stent configuration on cerebral aneurysm fluid dynamics

Babiker, M. Haithem; Gonzalez, L. Fernando; Ryan, Justin; Albuquerque, Felipe C.; Collins, Daniel; Elvikis, Arius; Frakes, David

doi:10.1016/j.jbiomech.2011.12.016

Cited by 64 publications

(35 citation statements)

References 31 publications

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“…Appanaboyina et al [9] simulated half-Y and Y stent deployments on basilar artery tip aneurysm models and found a reduction in aneurysmal velocity and WSS. Babiker et al [10] studied the hemodynamic effect of three stent configurations (half-Y, Y and, cross-bar) across the necks of basilar artery tip aneurysm models and concluded that the Y configuration reduced cross-neck flow most, while a cross-bar configuration reduced velocity magnitude within the aneurysm most. We also clarified the most intraaneurysm velocity reduction with a cross-bar configuration.…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies were validation studies and did not consider clinical therapy options, especially for double closed-cell Enterprise stents, which are applied clinically [5][6][7], or used one or two hemodynamic parameters such as velocity and wall shear stress (WSS) without conducting a comparison of important hemodynamic parameters (velocity, pressure, and WSS) for all three stent configurations [8][9][10]. Other studies investigated only the relationship between Y or half-Y stent-induced angular remodeling and aneurismal hemodynamics [11,12], and thus the results may not reflect the aneurismal hemodynamic changes with different stent configurations in detail.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hemodynamic Alterations for Various Stent Configurations in Idealized Wide-neck Basilar Tip Aneurysm

et al. 2016

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Stent-assisted coiling technology is widely used in the treatment of intracranial aneurysms. However, differences among various stent configurations have not been fully characterized. This study investigates the hemodynamic effects for various stent configurations. Computational fluid dynamics simulations were performed on an idealized wide-neck basilar tip aneurysm model, which was constructed from digital subtraction angiography images with a virtual stenting technique. The orifice of the aneurysm was tilted toward the left posterior cerebral artery (PCA). The right half-Y configuration caused only a small change in the overall intra-aneurysmal flow pattern compared with the pattern produced without a stent. Percentage of hemodynamic changes were all compared to the untreated aneurysm.The values of wall shear stress (WSS) and flow velocity showed reductions of 16.36 and 3.22 %, respectively. Although the Y configuration showed relatively obvious decreases of 56.27 and 33.55 % in WSS and flow velocity, respetively, the left half-Y configuration, which is usually deployed as the first stent clinically, produced a more obvious flow reduction than those of the right half-Y and Y configurations. Consistent decreases in the velocity and WSS were observed. WSS and flow velocity showed reductions of 58.39 and 41.76 %, respectively. The cross-bar configuration showed the highest WSS and flow velocity reductions (58.42 and 46.49 %, respectively). The right half-Y configuration had relative more impacts on the WSS of the right PCoA than the left half-Y configuration. For the Y and crossbar configurations, the WSS of the right PCA obviously decreased. The overall pressure change was less than 1 % for the various configurations, with the Y configuration having the highest pressure increase (0.728 %). Simulation results demonstrate obvious differences among the various stent configurations in a wide-neck basilar tip aneurysm.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hemodynamic Alterations for Various Stent Configurations in Idealized Wide-neck Basilar Tip Aneurysm

et al. 2016

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“…Using the ITK-SNAP code [30], we constructed three-dimensional representation of vessels in the anomaly area. The model of the stent used during the surgery is applied only for remodelling the shape of a vessel so that a coarse stent becomes a part of the wall after its deployment [3].…”

Section: Mathematical Modelmentioning

confidence: 99%

“…The in uence of the geometry of the stent and vascular intracranial aneurysms were considered in [3,5]. A simulation of owredirecting stent deployment was performed in [15].…”

mentioning

confidence: 99%

Nonstationary Hemodynamics Modelling in a Cerebral Aneurysm of a Blood Vessel

Yanchenko

Cherevko²,

Чупахин

et al. 2014

Russian Journal of Numerical Analysis and Mathematical Modelling

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Computer simulation is carried out for unsteady hemodynamics in a cerebral aneurysm of a blood vessel. Using the data of a real patient obtained in medical examination and during surgery, we reconstruct the 3D geometry of the anomaly, calculate hydrodynamic parameters of blood ow ( ow velocity, streamline distribution, pressure, shear stress on walls, energy ux) and the deformation and stresses of the vessel walls. The calculations were performed for the following three cases: in the presence of an aneurysm, immediately after stent deployment changing the geometry of the vessel, and one year after the surgery. It is shown what changes of hydrodynamic and mechanical quantities characterize a successful surgery.The vascular system of the brain is highly susceptible to anomalies and pathologies due to peculiar intensity of its work in comparison with other organs. Cerebral arterial aneurysms are the most common anomalies. They are a pathological local expansion of a vessel caused by in ation of one layers of its wall, namely, intima, which is the most subtle and least durable. This violates the geometry of the vessel and normal blood ow in it. Since the aneurysm dome is thinner than the vessel wall, in most cases there is a risk of rupture just at this place, which leads to hemorrhage. The aneurysm treatment scenario depends on many factors.The hemodynamics in a neighbourhood of an aneurysm is intensively studied now. The in uence of the geometry of the stent and vascular intracranial aneurysms were considered in [3,5]. A simulation of owredirecting stent deployment was performed in [15]. An evaluation of stresses on the wall of an abdominal aortic aneurysms was done in [10]. The simulation results for the ow with an installed stent in the abdominal aorta was described in [12]. Mechanical properties of stents were studied in [13].Currently, the outcome of the surgery depends on the skill of a particular surgeon. The medical aspects of the problem were described in details in [7]. This paper is aimed to application of the methods of mathematical modelling to this complicated area.Stents are often used for the surgery of arterial aneurysms without neck or aneurysms located in the bifurcation (branching) of vessels. There are many designs of stents used for di erent purposes. Any stent is a delicate, generally cylindrical, metal, or plastic construction. The stent is delivered to the place with an intravascular instrument and then is spread inside with a special removable bulb which increases its diameter and presses it into the vessel wall. The design of the stent ensures the preservation of its straightened con guration. In this paper we consider coarse elastic stents which practically do not block the lumen of the vessel but, due to their elasticity, gradually correct pathological bends of vessels. The stenting was not aimed at strengthening the walls in the zone of aneurysm and hence stents are positioned so that they do not touch initially the dome of the aneurysm. Mechanical properties of vessel walls in the zone...

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“…Nevertheless, we believe that the simulated flow conditions provide good indications of the general flow changes after treatment. In fact, several previous studies have demonstrated that steady state conditions provide good indications of flow trends that result under pulsatile flow conditions(Babiker et al, 2012;Mantha, Benndorf, Hernandez, & Metcalfe, 2009) and that the influence of parent vessel flow is secondary to geometry(Cebral, Mut, Weir, & Putman, 2011;Mantha et al, 2009). Accordingly, we have focused on geometric change (in the form of different aneurysmal geometries) and blood flow direction as the primary factors underlying fluid dynamic change.…”

mentioning

confidence: 99%