Characterization of Cerebral Aneurysms for Assessing Risk of Rupture by Using Patient-Specific Computational Hemodynamics Models

2006 ◽  
Vol 2006 ◽  
pp. 350-351 ◽  
Author(s):  
A.G. Osborn
2012 ◽  
Vol 2012 ◽  
pp. 1-24 ◽  
Author(s):  
Jürgen Endres ◽  
Markus Kowarschik ◽  
Thomas Redel ◽  
Puneet Sharma ◽  
Viorel Mihalef ◽  
...  

Increasing interest is drawn on hemodynamic parameters for classifying the risk of rupture as well as treatment planning of cerebral aneurysms. A proposed method to obtain quantities such as wall shear stress, pressure, and blood flow velocity is to numerically simulate the blood flow using computational fluid dynamics (CFD) methods. For the validation of those calculated quantities, virtually generated angiograms, based on the CFD results, are increasingly used for a subsequent comparison with real, acquired angiograms. For the generation of virtual angiograms, several patient-specific parameters have to be incorporated to obtain virtual angiograms which match the acquired angiograms as best as possible. For this purpose, a workflow is presented and demonstrated involving multiple phantom and patient cases.


Author(s):  
Paul N. Watton ◽  
Yiannis Ventikos ◽  
Gerhard A. Holzapfel

Cerebral aneurysms are thought to be present in 2–5% of the general population. Most aneurysms remain asymptomatic and of those that are detected, the risk of rupture is relatively low, i.e. 0.1–1% per year. However, very high morbidity and mortality rates are associated with an aneurysm that does rupture (30–50%). Consequently, elective repair of an aneurysm at high risk of rupture may be deemed appropriate. Unfortunately, interventional procedures are themselves not without risk and have morbidity rates of up to 6%. Moreover, it is difficult to quantify the risk of rupture on a patient specific basis: more sophisticated diagnostic criteria are required. Computational models of aneurysm evolution aim to improve the understanding of the aetiology of the disease. The ultimate aim is to predict future evolution and rupture.


2020 ◽  
Vol 2020 ◽  
pp. 1-20
Author(s):  
Cosmin-Ioan Nita ◽  
Takashi Suzuki ◽  
Lucian Mihai Itu ◽  
Viorel Mihalef ◽  
Hiroyuki Takao ◽  
...  

In recent years, computational fluid dynamics (CFD) has become a valuable tool for investigating hemodynamics in cerebral aneurysms. CFD provides flow-related quantities, which have been shown to have a potential impact on aneurysm growth and risk of rupture. However, the adoption of CFD tools in clinical settings is currently limited by the high computational cost and the engineering expertise required for employing these tools, e.g., for mesh generation, appropriate choice of spatial and temporal resolution, and of boundary conditions. Herein, we address these challenges by introducing a practical and robust methodology, focusing on computational performance and minimizing user interaction through automated parameter selection. We propose a fully automated pipeline that covers the steps from a patient-specific anatomical model to results, based on a fast, graphics processing unit- (GPU-) accelerated CFD solver and a parameter selection methodology. We use a reduced order model to compute the initial estimates of the spatial and temporal resolutions and an iterative approach that further adjusts the resolution during the simulation without user interaction. The pipeline and the solver are validated based on previously published results, and by comparing the results obtained for 20 cerebral aneurysm cases with those generated by a state-of-the-art commercial solver (Ansys CFX, Canonsburg PA). The automatically selected spatial and temporal resolutions lead to results which closely agree with the state-of-the-art, with an average relative difference of only 2%. Due to the GPU-based parallelization, simulations are computationally efficient, with a median computation time of 40 minutes per simulation.


Author(s):  
Matthew D. Ford ◽  
Sang-Wook Lee ◽  
Stephen P. Lownie ◽  
David W. Holdsworth ◽  
David A. Steinman

The prevalence of unruptured cerebral aneurysms is estimated to be as high as 5% [1]. Basilar tip aneurysms account for 4–5% of these, but have a higher risk of rupture [2]. They are also difficult to treat surgically, and so endovascular therapy is often the only option. Hemodynamic forces have been implicated in the risk of rupture [3] and complications of endovascular therapy [4]; however, hemodynamic information is difficult to acquire clinically. Computational fluid dynamics (CFD), in combination with clinical imaging, can be used to accurately capture the intra-aneurysmal hemodynamics in a patient-specific manner [5]. Still, these techniques have not translated to routine clinical use, largely due to the time and effort required to construct, simulate, and interpret these models.


Author(s):  
Zijing Zeng ◽  
David F. Kallmes ◽  
Yong Hong Ding ◽  
Ramanathan Kadirvel ◽  
Debra A. Lewis ◽  
...  

An intracranial aneurysm (IA) is a pathological condition of cerebral arteries characterized by local enlargements of the arterial wall, typically into a saccular shape. Rupture of the aneurysm sac can result in devastating cerebral hemorrhage. Hemodynamic factors are believed to play an important role in initiation, development and rupture of IAs [1–3]. However, the coupling between hemodynamics and aneurysm pathophysiology is complex and remains poorly understood. Patient specific diagnostics regarding risk of rupture can be substantially advanced by improving our understanding of the in-vivo response of the aneurysm wall to intra-saccular hemodynamic stresses. A mechanism for fundamental studies of the impact of chronically altered WSS on the intact vascular wall is provided by animal models. However, cerebral aneurysms have not been shown to occur naturally in animals. Thus, a number of animal models have been created for studying aneurysm pathogenesis including those in mice, rats, rabbits, canines, swine and primates. To make meaningful use of these models, it is important to evaluate their relevance to human biomechanics and pathophysiology.


2010 ◽  
Vol 22 (5) ◽  
pp. 639-646 ◽  
Author(s):  
Sheng-zhang Wang ◽  
Jia-liang Chen ◽  
Guang-hong Ding ◽  
Gang Lu ◽  
Xiao-long Zhang

2021 ◽  
Vol 11 (4) ◽  
pp. 520
Author(s):  
Emily R. Nordahl ◽  
Susheil Uthamaraj ◽  
Kendall D. Dennis ◽  
Alena Sejkorová ◽  
Aleš Hejčl ◽  
...  

Computational fluid dynamics (CFD) has grown as a tool to help understand the hemodynamic properties related to the rupture of cerebral aneurysms. Few of these studies deal specifically with aneurysm growth and most only use a single time instance within the aneurysm growth history. The present retrospective study investigated four patient-specific aneurysms, once at initial diagnosis and then at follow-up, to analyze hemodynamic and morphological changes. Aneurysm geometries were segmented via the medical image processing software Mimics. The geometries were meshed and a computational fluid dynamics (CFD) analysis was performed using ANSYS. Results showed that major geometry bulk growth occurred in areas of low wall shear stress (WSS). Wall shape remodeling near neck impingement regions occurred in areas with large gradients of WSS and oscillatory shear index. This study found that growth occurred in areas where low WSS was accompanied by high velocity gradients between the aneurysm wall and large swirling flow structures. A new finding was that all cases showed an increase in kinetic energy from the first time point to the second, and this change in kinetic energy seems correlated to the change in aneurysm volume.


Author(s):  
Karol Calò ◽  
Giuseppe De Nisco ◽  
Diego Gallo ◽  
Claudio Chiastra ◽  
Ayla Hoogendoorn ◽  
...  

Atherosclerosis at the early stage in coronary arteries has been associated with low cycle-average wall shear stress magnitude. However, parallel to the identification of an established active role for low wall shear stress in the onset/progression of the atherosclerotic disease, a weak association between lesions localization and low/oscillatory wall shear stress has been observed. In the attempt to fully identify the wall shear stress phenotype triggering early atherosclerosis in coronary arteries, this exploratory study aims at enriching the characterization of wall shear stress emerging features combining correlation-based analysis and complex networks theory with computational hemodynamics. The final goal is the characterization of the spatiotemporal and topological heterogeneity of wall shear stress waveforms along the cardiac cycle. In detail, here time-histories of wall shear stress magnitude and wall shear stress projection along the main flow direction and orthogonal to it (a measure of wall shear stress multidirectionality) are analyzed in a representative dataset of 10 left anterior descending pig coronary artery computational hemodynamics models. Among the main findings, we report that the proposed analysis quantitatively demonstrates that the model-specific inlet flow-rate shapes wall shear stress time-histories. Moreover, it emerges that a combined effect of low wall shear stress magnitude and of the shape of the wall shear stress–based descriptors time-histories could trigger atherosclerosis at its earliest stage. The findings of this work suggest for new experiments to provide a clearer determination of the wall shear stress phenotype which is at the basis of the so-called arterial hemodynamic risk hypothesis in coronary arteries.


Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Yoshifumi Hayashi ◽  
Takanobu Yagi ◽  
Yasutaka Tobe ◽  
Yuki Iwabuchi ◽  
Momoko Yamanashi ◽  
...  

[Background and purpose] During a clipping surgery, an unruptured intracerebral aneurysm often presented a spatially-localized red-colored "wall-thinning" area. The wall thinning was believed to be related with the risk of rupture. The present aim is given to investigate the predictability of a wall thinning area using computational fluid dynamics (CFD). [Method] We chose 16 unruptured aneurysms (12 MCA, 4 ICA) with clipping surgery and 24 wall-thinning areas were detected from the operation video. CFD study was carried out using patient-specific angiographic data. The wall shear stress (WSS) and the wall pressure were evaluated. [Results] The WSS magnitude was found to be uncorrelated with wall thinning. On the other hand, 20 wall-thinning areas (83%) exhibited a presence of “flow impingement”, which was defined to give the spatial variation of the WSS vector to be divergent with the local elevation of the wall pressure. From CFD, 27 flow impingements were detected and classified according to the degree of divergence. Seven impingements are full-divergent and all of them (100%) are located in the wall thinning areas. The remaining 20 impingements were partial-divergent and 13 impingements of them (65%) were located in the wall thinning areas. A classification of full-/partial-divergent flow impingement was statistically significant for the prediction of wall-thinning areas (P<0.01). [Conclusions] The full-divergent flow impingement was found to be a reliable predictor of the wall thinning area in unruptured intracerebral aneurysms. The present results demonstrated the malignant nature of flow impingement for promoting the thinning of aneurysmal walls.


2022 ◽  
pp. 110919
Author(s):  
Simbarashe G. Chidyagwai ◽  
Madhurima Vardhan ◽  
Michael Kaplan ◽  
Reid Chamberlain ◽  
Piers Barker ◽  
...  

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