Numerical simulation of flow-diverting stent: comparison between branches in bifurcation brain aneurysm

Abstract

The usage of ow-diverting stents in the treatment of intracranial aneurysms is widespread due to their high success and low complication rates. However, their use is still not o cially recommended for bifurcation aneurysms, as there is a risk of generating ischemic complications due to the reduced blood ow to the jailed branch. Many works utilize computational uid dynamics (CFD) to study how hemodynamic variables respond to ow diverter placement, but few seem to use it to verify ow variation between branches of bifurcation aneurysms and to aid in the choice of the best rami cation for device placement. This investigation was performed in the present work, by comparing wall shear stress (WSS) and owrates for a patient-speci c scenario of a Middle Cerebral Artery (MCA) aneurysm, considering device placement on each branch. A secondary objective was to follow a methodology that provides fast results, envisioning application to daily medical practice. The device was simpli ed as a homogeneous porous medium and extreme porosity values were simulated for comparison. Results suggest that stent placement on either branch is both safe and effective, signi cantly reducing WSS and ow into the aneurysm while maintaining ow to the different rami cations within acceptable thresholds.

Prediction of Hemodynamic-Related Hemolysis in Carotid Stenosis and Aiding in Treatment Planning and Risk Stratification Using Computational Fluid Dynamics

“…CFD can provide information on high shear stress [10,[63][64][65], which is one of the factors causing blood hemolysis, which negatively affects patients' health [74]. In addition, computational methods allow for the improvement of stents [75][76][77][78][79][80][81][82] used in PCI, or allow one to obtain "virtual" results of FFR measurements [83][84][85][86][87][88]. A wide range of computer simulation methods allows for extensive support of medics.…”