2018
DOI: 10.1371/journal.pone.0190696
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Phase-contrast MRI versus numerical simulation to quantify hemodynamical changes in cerebral aneurysms after flow diverter treatment

Abstract: Cerebral aneurysms are a major risk factor for intracranial bleeding with devastating consequences for the patient. One recently established treatment is the implantation of flow-diverters (FD). Methods to predict their treatment success before or directly after implantation are not well investigated yet. The aim of this work was to quantitatively study hemodynamic parameters in patient-specific models of treated cerebral aneurysms and its correlation with the clinical outcome. Hemodynamics were evaluated usin… Show more

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Cited by 28 publications
(24 citation statements)
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“…First, whereas a range of VENC values has been used in the literature, we chose a VENC of 80 cm/s in accordance with Markl et al 38 for intracranial vessel measurements. Other 4D-PCMR studies used, VENCs of 120 cm/s, 39 100 cm/s, 20 and a range of 60-80 cm/s 21 for pre-and poststent acquisitions. Our main limitation, with a potential impact on the results, was the choice of the poststent VENC, which led us to decrease this parameter from 80 cm/s (the first 17 patients) to 40 cm/s (in the remaining 6 patients) to capture the low velocities more accurately at the expense of aliasing artifacts.…”
Section: Limitationsmentioning
confidence: 99%
See 1 more Smart Citation
“…First, whereas a range of VENC values has been used in the literature, we chose a VENC of 80 cm/s in accordance with Markl et al 38 for intracranial vessel measurements. Other 4D-PCMR studies used, VENCs of 120 cm/s, 39 100 cm/s, 20 and a range of 60-80 cm/s 21 for pre-and poststent acquisitions. Our main limitation, with a potential impact on the results, was the choice of the poststent VENC, which led us to decrease this parameter from 80 cm/s (the first 17 patients) to 40 cm/s (in the remaining 6 patients) to capture the low velocities more accurately at the expense of aliasing artifacts.…”
Section: Limitationsmentioning
confidence: 99%
“…The latter presents the major advantage of being the only quantitative method for the in vivo measurement of 3D velocity fields over time, and some neurovascular disorders have been addressed with this technique, such as arteriovenous malformation hemodynamics. 19 Regarding IAs treated with FDSs, only a limited number of in vitro studies 20 have been performed, and even fewer in vivo studies have included a maximum of 10 patients. This lack of data has prevented determination of any correlation with the resultant treatment outcomes.…”
mentioning
confidence: 99%
“…It is important to note that the utilized FVS technique was validated with in vivo and in vitro experiments and has been applied to several clinically relevant research topics. 24,25,28 The virtual stenting results for this study were reviewed by an experienced neuroradiologist.…”
Section: Virtual Stent Deploymentmentioning
confidence: 99%
“…Computational fluid dynamics has been used for over a decade to assess the hemodynamics of intracranial aneurysms after flow diversion treatment. [1][2][3][4][5][6] This is because a favorable treatment outcome is largely associated with the efficacy of flow diversion produced by the implanted device; redirecting much of the aneurysmal inflow can 'weaken' the hemodynamic activity inside the sac, thereby promoting thrombosis and accelerating intracranial aneurysm occlusion. 7 In view of this mechanism, a wide variety of hemodynamic parameters have been proposed to quantify the efficacy of flow-diverting (FD) stents: from those measuring reduction of the aneurysmal inflow strength (eg, aneurysmal inflow rate, intraaneurysmal average velocity, mean aneurysm flow amplitude) [8][9][10][11] to those measuring weakening of the vascular pressure or stress (eg, wall shear stress, pressure drop), 2 12 13 and then to those characterizing changes in flow behavior within the aneurysm sac (eg, relative residence time, vortex core-line length).…”
Section: Introductionmentioning
confidence: 99%
“…In view of this mechanism, a wide variety of hemodynamic parameters have been proposed to quantify the efficacy of flow-diverting (FD) stents: from those measuring reduction of the aneurysmal inflow strength (eg, aneurysmal inflow rate, intra-aneurysmal average velocity, mean aneurysm flow amplitude) 8–11 to those measuring weakening of the vascular pressure or stress (eg, wall shear stress, pressure drop), 2 12 13 and then to those characterizing changes in flow behavior within the aneurysm sac (eg, relative residence time, vortex core-line length). 8 14 15 Furthermore, many research groups have also attempted to establish hemodynamic identifiers of a successful treatment, 4 9 12 13 16–19 although no consensus has yet been reached.…”
Section: Introductionmentioning
confidence: 99%