Nicolás Dazeo1, Romina Muñoz2, Ana Paula Narata3, Hector Fernandez4, Ignacio Larrabide2,4. 1. Instituto Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina. ndazeo@conicet.gov.ar. 2. Instituto Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina. 3. Neuroradiology Department, University Hospital of Southampton, Southampton, UK. 4. Galgo Medical S.L., Barcelona, Spain.
Abstract
MOTIVATION: Intra-saccular devices (ID), developed for the treatment of bifurcation aneurysms, offer new alternatives for treating complex terminal and bifurcation aneurysms. In this work, a complete workflow going from medical images to post-treatment CFD analysis is described and used in the assessment of a concrete clinical problem. MATERIALS AND METHODS: Two different intra-saccular device sizes were virtually implanted in 3D models of the patient vasculature using the ID-Fit method. After deployment, the local porosity at the closed end of the device in contact with the blood flow was computed. This porosity was then used to produce a CFD porous medium model of the device. Velocities and wall shear stress were assessed for each model. RESULTS: Six patients treated with intra-saccular devices were included in this work. For each case, 2 different device sizes were virtually implanted and 3 CFD simulations were performed: after deployment simulation with each size and before deployment simulation (untreated). A visible reduction in velocities was observed after device implantation. Velocity and WSS reduction was statistically significant (K-S statistics, [Formula: see text]). CONCLUSIONS: Placement of different device size can lead to a partial filling of the aneurysm, either at the dome or at the neck, depending on the particular positioning by the interventionist. The methodology used in this work can have a strong clinical impact, since it provides additional information in the process of device selection using preoperative data.
MOTIVATION: Intra-saccular devices (ID), developed for the treatment of bifurcation aneurysms, offer new alternatives for treating complex terminal and bifurcation aneurysms. In this work, a complete workflow going from medical images to post-treatment CFD analysis is described and used in the assessment of a concrete clinical problem. MATERIALS AND METHODS: Two different intra-saccular device sizes were virtually implanted in 3D models of the patient vasculature using the ID-Fit method. After deployment, the local porosity at the closed end of the device in contact with the blood flow was computed. This porosity was then used to produce a CFD porous medium model of the device. Velocities and wall shear stress were assessed for each model. RESULTS: Six patients treated with intra-saccular devices were included in this work. For each case, 2 different device sizes were virtually implanted and 3 CFD simulations were performed: after deployment simulation with each size and before deployment simulation (untreated). A visible reduction in velocities was observed after device implantation. Velocity and WSS reduction was statistically significant (K-S statistics, [Formula: see text]). CONCLUSIONS: Placement of different device size can lead to a partial filling of the aneurysm, either at the dome or at the neck, depending on the particular positioning by the interventionist. The methodology used in this work can have a strong clinical impact, since it provides additional information in the process of device selection using preoperative data.
Entities:
Keywords:
Aneurysm; Intra-saccular device; Porous media
Authors: J R Cebral; B J Chung; F Mut; J Chudyk; C Bleise; E Scrivano; P Lylyk; R Kadirvel; D Kallmes Journal: AJNR Am J Neuroradiol Date: 2019-08-08 Impact factor: 3.825
Authors: David A Steinman; Jaques S Milner; Chris J Norley; Stephen P Lownie; David W Holdsworth Journal: AJNR Am J Neuroradiol Date: 2003-04 Impact factor: 3.825