Unraveling the relationship between arterial flow and intra-aneurysmal hemodynamics

Morales, Hernán G.; Bonnefous, O.

doi:10.1016/j.jbiomech.2015.01.016

Cited by 21 publications

(17 citation statements)

References 33 publications

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“…It was confirmed in untreated aneurysm models that the vel sa linearly depends on Q (R 2 Ͼ 0.995), 12 and this linear relationship was extended for stented aneurysms (R 2 Ͼ 0.983). Indeed, from a hemodynamic point of view, a stented aneurysm is like another aneurysm with a particular resistance near the ostium (obtained by the stent), and this law is preserved.…”

Section: Linear Lawmentioning

confidence: 81%

“…Inside the aneurysm, the spatiotemporal-averaged flow velocity, vel sa , was calculated, which has been shown to be independent of the waveform shape. 12,24 Per case, linear regression models were applied to the untreated and stented datasets. The goal was to confirm that vel sa can be characterized as a linear function of Q (see Equation 1) for untreated aneurysms 12 and to extend this characterization of the vel sa after treatment under the hypothesis that this relationship should be preserved.…”

Section: Discussionmentioning

confidence: 99%

“…More details about the mesh strategies can be found elsewhere. [10][11][12] In these volumetric meshes, governing equations of flow motion were solved by using the open-source computational fluid dynamics (CFD) package OpenFOAM 2.2.1 (www.openfoam. org).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Does Arterial Flow Rate Affect the Assessment of Flow-Diverter Stent Performance?

Morales

Bonnefous

Geers

et al. 2016

AJNR Am J Neuroradiol

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Section: Linear Lawmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Does Arterial Flow Rate Affect the Assessment of Flow-Diverter Stent Performance?

Morales

Bonnefous

Geers

et al. 2016

AJNR Am J Neuroradiol

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“…Among the above‐mentioned studies, Castro et al, Morales et al, and Fisher and Rossmann performed quantitative comparisons between time‐and‐space‐averaged aneurysmal WSS values obtained from CFD simulations based on Newtonian and non‐Newtonian (Casson) rheology and reported values of time‐and‐space‐averaged WSS on the aneurysm sac for different cases. According to a random‐effects meta‐analysis, the SMD (Hedges’ g ) was 0.02 with a 95% confidence interval of −0.04 to 0.07.…”

Section: Vascular Surface and Blood Flow Modelingmentioning

confidence: 99%

Virtual endovascular treatment of intracranial aneurysms: models and uncertainty

Sarrami‐Foroushani

Lassila

Frangi

2017

WIREs Mechanisms of Disease

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Virtual endovascular treatment models (VETMs) have been developed with the view to aid interventional neuroradiologists and neurosurgeons to pre-operatively analyze the comparative efficacy and safety of endovascular treatments for intracranial aneurysms. Based on the current state of VETMs in aneurysm rupture risk stratification and in patient-specific prediction of treatment outcomes, we argue there is a need to go beyond personalized biomechanical flow modeling assuming deterministic parameters and error-free measurements. The mechanobiological effects associated with blood clot formation are important factors in therapeutic decision making and models of post-treatment intra-aneurysmal biology and biochemistry should be linked to the purely hemodynamic models to improve the predictive power of current VETMs. The influence of model and parameter uncertainties associated to each component of a VETM is, where feasible, quantified via a random-effects meta-analysis of the literature. This allows estimating the pooled effect size of these uncertainties on aneurysmal wall shear stress. From such meta-analyses, two main sources of uncertainty emerge where research efforts have so far been limited: (1) vascular wall distensibility, and (2) intra/intersubject systemic flow variations. In the future, we suggest that current deterministic computational simulations need to be extended with strategies for uncertainty mitigation, uncertainty exploration, and sensitivity reduction techniques. WIREs Syst Biol Med 2017, 9:e1385. doi: 10.1002/wsbm.1385 For further resources related to this article, please visit the WIREs website.

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“…5,31,36 Image-based CFD is subject to numerous sources of uncertainty along its pipeline: the clinical modality used to image the aneurysm 4,16,17 ; digital segmentation of the lumen, often requiring subjective decisions about thresholds, filtering, smoothing, etc. 15,34,38 ; truncation of the domain and attendant assumptions about velocity boundary conditions 7,19,30 ; the need to assume flow rates, 21,25,32 since patient-specific measurements are rarely available; the pragmatic assumption of rigid walls 2,12,46 and simple blood rheologies 6,27,48 when, similarly, patient-specific properties are difficult or impossible to obtain; and the choice of mesh and time-step resolutions, as well as other CFD solver settings. 13,44,45 Common to the above-cited studies is that they were performed by individual research teams and focused on a single source of variability, all other factors being equal.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Impact of Wrong Positioning of a Dedicated Stent for Coronary Bifurcations: A Virtual Bench Testing Study

Chiastra

Grundeken

Collet

et al. 2018

Cardiovasc Eng Tech

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Associate Editors Francesco Migliavacca and Ajit P. Yoganathan oversaw the review of this article.Abstract Purpose-Image-based computational fluid dynamics (CFD) is widely used to predict intracranial aneurysm wall shear stress (WSS), particularly with the goal of improving rupture risk assessment. Nevertheless, concern has been expressed over the variability of predicted WSS and inconsistent associations with rupture. Previous challenges, and studies from individual groups, have focused on individual aspects of the image-based CFD pipeline. The aim of this Challenge was to quantify the total variability of the whole pipeline. Methods-3D rotational angiography image volumes of five middle cerebral artery aneurysms were provided to participants, who were free to choose their segmentation methods, boundary conditions, and CFD solver and settings. Participants were asked to fill out a questionnaire about their solution strategies and experience with aneurysm CFD, and provide surface distributions of WSS magnitude, from which we objectively derived a variety of hemodynamic parameters. Results-A total of 28 datasets were submitted, from 26 teams with varying levels of self-assessed experience. Wide variability of segmentations, CFD model extents, and inflow rates resulted in interquartile ranges of sac average WSS up to 56%, which reduced to < 30% after normalizing by parent artery WSS. Sac-maximum WSS and low shear area were more variable, while rank-ordering of cases by low or high shear showed only modest consensus among teams. Experience was not a significant predictor of variability. Conclusions-Wide variability exists in the prediction of intracranial aneurysm WSS. While segmentation and CFD solver techniques may be difficult to standardize across groups, our findings suggest that some of the variability in image-based CFD could be reduced by establishing guideli- Cardiovascular Engineering and Technology, Vol. 9, No. 4, December 2018 (Ó 2018) pp. 544-564 https://doi.org/10.1007/s13239-018-00374-2 1869-408X/18/1200-0544/0 Ó 2018 The Author(s) 544 nes for model extents, inflow rates, and blood properties, and by encouraging the reporting of normalized hemodynamic parameters.

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Unraveling the relationship between arterial flow and intra-aneurysmal hemodynamics

Cited by 21 publications

References 33 publications

Does Arterial Flow Rate Affect the Assessment of Flow-Diverter Stent Performance?

Does Arterial Flow Rate Affect the Assessment of Flow-Diverter Stent Performance?

Virtual endovascular treatment of intracranial aneurysms: models and uncertainty

Biomechanical Impact of Wrong Positioning of a Dedicated Stent for Coronary Bifurcations: A Virtual Bench Testing Study

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