The Computational Fluid Dynamics Rupture Challenge 2013—Phase I: Prediction of Rupture Status in Intracranial Aneurysms

Janiga, Gábor; Berg, Philipp; Sugiyama, Shunsuke; Kono, Kenichi; Steinman, David A.

doi:10.3174/ajnr.a4157

Cited by 74 publications

(53 citation statements)

References 26 publications

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“…Recent advances in computational fluid dynamics (CFD) have enabled us to evaluate the hemodynamics of intracranial aneurysms with increasing reliability and accuracy. [19][20][21][22][23] Using state-of-the-art techniques, several studies have reported the influence of blood flow on the results of coil embolization for intracranial aneurysms. [24][25][26][27][28][29] In this study, we investigated the hemodynamics of basilar tip aneurysms with special attention to the volume of blood flow into aneurysms through the neck.…”

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confidence: 99%

Blood Flow Into Basilar Tip Aneurysms

Sugiyama

Niizuma

Sato

et al. 2016

Stroke

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We retrospectively investigated the clinical and radiological data from 111 consecutive patients who underwent endovascular treatment Background and Purpose-Hemodynamic forces may play a role in the recanalization of coiled aneurysms. The purpose of this study was to investigate the influence of presurgical hemodynamics on the efficacy of coil embolization for basilar tip aneurysms. Methods-We identified 82 patients who underwent endovascular coil embolization for basilar tip aneurysms with a followup of >1 year. Presurgical hemodynamics were investigated using computational fluid dynamics with 3-dimensional data derived from rotational angiography. During postprocessing, we quantified the rate of net flow entering the aneurysm through its neck and calculated the proportion of the aneurysmal inflow rate to the basilar artery flow rate. In addition, we investigated the correlation between the basilar bifurcation configuration and the hemodynamics. Results-Twenty-five of the 82 patients were excluded because of difficult vascular geometry reconstruction. Among the 57 examined patients, angiographic recanalization was observed in 19 patients (33.3%). The proportion of the aneurysmal inflow rate to the basilar artery flow rate and a coil packing density <30% were independent and significant predictors for the recanalization of coiled aneurysms. Additional investigation revealed that a small branch angle formed by the basilar artery and the posterior cerebral artery increased blood flow into the aneurysm. Conclusions-The proportion of the aneurysmal inflow rate to the basilar artery flow rate, influenced by the basilar bifurcation configuration, was an independent and significant predictor for recanalization after coil embolization in basilar tip aneurysms.

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confidence: 99%

Blood Flow Into Basilar Tip Aneurysms

Sugiyama

Niizuma

Sato

et al. 2016

Stroke

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“…9, 12 Our hemodynamics RRS model was validated in another 85 aneurysms by our Buffalo-based research group. 12 Furthermore, this model was able to correctly distinguish ruptured MCA aneurysms from unruptured MCA aneurysms and also predicted the rupture region for the ruptured MCA aneurysms in the 2013 CFD challenge; 23 in addition, our hemodynamics RRS model was able to accurately predict the two ruptured MCA aneurysms from the three unruptured MCA aneurysms with similar size and shape in the 2015 CFD challenge (Varble N, Meng H: unpublished data, February 2015). Although RRS can potentially detect a high similarity of new IAs to already ruptured IAs in our cohort, future longitudinal studies should investigate the ability of RRS to predict eventual rupture.…”

Section: Discussionmentioning

confidence: 89%

“…20, 21 Three recent CFD challenges, in 2012, 22 2013, 23 and 2015 (http://cfdchallenge2015.c.ooco.jp/index2.html), have pushed the frontiers of image-based CFD for IAs. In the 2015 CFD challenge, 28 groups of CFD researchers were asked to predict the rupture status for 5 ruptured MCA aneurysms through hemodynamics calculation.…”

Section: Discussionmentioning

confidence: 99%

Initial Clinical Experience with AView—A Clinical Computational Platform for Intracranial Aneurysm Morphology, Hemodynamics, and Treatment Management

et al. 2017

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Background Intracranial aneurysm (IA) management is challenging. Clinicians often rely on varied and intuitively disparate ways of evaluating rupture risk that may only partially take into account complex hemodynamic and morphologic factors. We developed a prototype of a clinically-oriented, streamlined, computational platform, AView, for rapid assessment of hemodynamics and morphometrics in clinical settings. To show the potential clinical utility of AView, we report our initial multicenter experience highlighting the possible advantages of morphologic and hemodynamic analysis of IAs. Methods AView software was deployed across 8 medical centers(6 US, 2 Japan). Eight clinicians were trained and used the AView software between September 2012 and January 2013. Results We present 12 illustrative cases that show the potential clinical utility of AView. For all, morphology and hemodynamics, flow visualization, and rupture resemblance score(a surrogate for rupture risk) were provided. In 3 cases, AView could confirm the clinicians’ decision to treat; in 3 cases, it could suggest which aneurysms may be at higher risk among multiple aneurysms; in 5 cases, AView could provide additional information for use during treatment decisions for ambiguous situations. In one stent-assisted coiling case, flow visualization predicted that the intuitive choice for stent placement could have resulted in sacrifice of an anterior cerebral artery due to blockage by coils and led clinicians to reconsider treatment plans. Conclusions AView has the potential to confirm decisions to treat IAs, suggest which among multiple aneurysms to treat, and guide treatment decisions. Furthermore, the flow visualization it affords can inform aneurysm treatment planning and potentially avoid poor outcomes.

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“…Zero‐pressure boundary conditions were imposed at all outlets. While this boundary condition does not necessarily lead to a physiological flow split between the outlet branches, it is used in many CFD studies because of the difficulty of determining patient‐specific values of the outlet resistances . The other commonly used way to compute flow splits between arterial branches, the Murray law, has been found to be violated in the circle of Willis .…”

Section: Methodsmentioning

confidence: 99%

Population‐specific modelling of between/within‐subject flow variability in the carotid arteries of the elderly

Lassila

Sarrami‐Foroushani

Hejazi

et al. 2019

Numer Methods Biomed Eng

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Computational fluid dynamics models are increasingly proposed for assisting the diagnosis and management of vascular diseases. Ideally, patient-specific flow measurements are used to impose flow boundary conditions. When patient-specific flow measurements are unavailable, mean values of flow measurements across small cohorts are used as normative values. In reality, both the between-subjects and within-subject flow variabilities are large. Consequently, neither one-shot flow measurements nor mean values across a cohort are truly indicative of the flow regime in a given person. We develop models for both the between-subjects and within-subject variability of internal carotid flow. A log-linear mixed effects model is combined with a Gaussian process to model the between-subjects flow variability, while a lumped parameter model of cerebral autoregulation is used to model the within-subject flow variability in response to heart rate and blood pressure changes. The model parameters are identified from carotid ultrasound measurements in a cohort of 103 elderly volunteers. We use the models to study intracranial aneurysm flow in 54 subjects under rest and exercise and conclude that OSI, a common wall shear-stress derived quantity in vascular CFD studies, may be too sensitive to flow fluctuations to be a reliable biomarker.KEYWORDS cerebrovascular disease, computational fluid dynamics, Gaussian process models, patient-specific models, uncertainty quantification Numerous computational fluid dynamics (CFD) models of human cardiovascular and cerebrovascular physiology are published every year, but few of them make any impact in clinical practice. This inconvenient truth has been blamed on the improper use of CFD solvers, 1 insufficient validation of biomechanics models, 2 and lack of understanding of the clinical decision-making process by the biomedical engineers building the models. 3 One additional explanation is that many "patient-specific" CFD models fail to consider the physiological variability of vascular flow, confounding interpretation of model results and producing overly confident predictions of flow quantities.Patient-specific modelling of vascular flow requires an accurate description of the lumen plus the definition of boundary conditions. The latter is done by measuring patient-specific flow waveforms using either phase contrast magnetic resonance imaging (pcMRI) or ultrasound-based flow measurement techniques. When patient-specific flow measurements are not available, cohort-averaged values of flow from the literature are often used. For example, the small-scale studies 4-6 Int J Numer Meth Biomed Engng. 2020;36:e3271.wileyonlinelibrary.com/journal/cnm

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The Computational Fluid Dynamics Rupture Challenge 2013—Phase I: Prediction of Rupture Status in Intracranial Aneurysms

Cited by 74 publications

References 26 publications

Blood Flow Into Basilar Tip Aneurysms

Blood Flow Into Basilar Tip Aneurysms

Initial Clinical Experience with AView—A Clinical Computational Platform for Intracranial Aneurysm Morphology, Hemodynamics, and Treatment Management

Population‐specific modelling of between/within‐subject flow variability in the carotid arteries of the elderly

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