Evaluation of stent effect and thrombosis generation with different blood rheology on an intracranial aneurysm by the Lattice Boltzmann method.

Background And Objective: Treatment of intracranial aneurysms with flow-diverting stents prevents rupture by reducing blood flow and creating thrombosis within the aneurysm. This paper aims to assess the hemodynamic effect of placing stents with different struts (0, 3, 5, 7 struts) on intracranial aneurysms and to propose a simple prediction model of thrombosis zone without any further computational cost.

Method: Lattice Boltzmann method with different rheological models (Newtonian, Carreau-Yasuda, KL) of blood are used to study the hemodynamic effect of flow-diverting stents in the aneurysm.

Neurovascular stent artifacts in 3D-TOF and 3D-PCMRI: Influence of stent design on flow measurement.

Purpose: The morphological and hemodynamic evaluations of neurovascular diseases treated with stents would benefit from noninvasive imaging techniques such as 3D time-of-flight MRI (3D-TOF) and 3D phase contrast MRI (3D-PCMRI). For this purpose, a comprehensive evaluation of the stent artifacts and their impact on the flow measurement is critical.

Methods: The artifacts of a representative sample of neurovascular stents were evaluated in vitro with 3D-TOF and 3D-PCMRI sequences.

Hemodynamics of Focal Versus Global Growth of Small Cerebral Aneurysms.

Background And Purpose: Hemodynamics play a driving role in the life cycle of brain aneurysms from initiation through growth until eventual rupture. The specific factors behind aneurysm growth, especially in small aneurysms, are not well elucidated. The goal of this study was to differentiate focal versus general growth and to analyze the hemodynamic microenvironment at the sites of enlargement in small cerebral aneurysms.

3D phase contrast MRI: Partial volume correction for robust blood flow quantification in small intracranial vessels.

Purpose: Recent advances in 3D-PCMRI (phase contrast MRI) sequences allow for measuring the complex hemodynamics in cerebral arteries. However, the small size of these vessels vs spatial resolution can lead to non-negligible partial volume artifacts, which must be taken into account when computing blood flow rates. For this purpose, we combined the velocity information provided by 3D-PCMRI with vessel geometry measured with 3DTOF (time of flight MRI) or 3DRA (3D rotational angiography) to correct the partial volume effects in flow rate assessments.

Geometrical deployment for braided stent.

The prediction of flow diverter stent (FDS) implantation for the treatment of intracranial aneurysms (IAs) is being increasingly required for hemodynamic simulations and procedural planning. In this paper, a deployment model was developed based on geometrical properties of braided stents. The proposed mathematical description is first applied on idealized toroidal vessels demonstrating the stent shortening in curved vessels.

Computational fluid dynamics analysis of flow reduction induced by flow-diverting stents in intracranial aneurysms: a patient-unspecific hemodynamics change perspective.

Background And Purpose: Flow-diverter stents (FDSs) have been used effectively to treat large neck and complex saccular aneurysms on the anterior carotid circulation. Intra-aneurysmal flow reduction induces progressive aneurysm thrombosis in most patients. Understanding the degree of flow modification necessary to induce complete aneurysm occlusion among patients with considerable hemodynamics variability may be important for treatment planning.

Determination of a shear rate threshold for thrombus formation in intracranial aneurysms.

Background: Particular intra-aneurysmal blood flow conditions, created naturally by the growth of an aneurysm or induced artificially by implantation of a flow diverter stent (FDS), can potentiate intra-aneurysmal thrombosis. The aim of this study was to identify hemodynamic indicators, relevant to this process, which could be used as a prediction of the success of a preventive endovascular treatment.

Method: A cross sectional study on 21 patients was carried out to investigate the possible association between intra-aneurysmal spontaneous thrombus volume and the dome to neck aspect ratio (AR) of the aneurysm.

Hemodynamic transition driven by stent porosity in sidewall aneurysms.

The healing process of intracranial aneurysms (IAs) treated with flow diverter stents (FDSs) depends on the IA flow modifications and on the epithelization process over the neck. In sidewall IA models with straight parent artery, two main hemodynamic regimes with different flow patterns and IA flow magnitude were broadly observed for unstented and high porosity stented IA on one side, and low porosity stented IA on the other side. The hemodynamic transition between these two regimes is potentially involved in thrombosis formation.

Computational fluid dynamics with stents: quantitative comparison with particle image velocimetry for three commercial off the shelf intracranial stents.

Background And Purpose: Validation of computational fluid dynamics (CFD) in stented intracranial aneurysms (IAs) is still lacking, to reliably predict prone to occlusion hemodynamics, probing, in particular, velocity reduction, and flow pattern changes. This study compares CFD outcome with particle imaging velocimetry (PIV) for three commercial off the shelf (COTS) stents of different material densities.

Material And Methods: The recently developed uniform and high precision multi-time lag PIV method was applied to a sidewall aneurysm before and after implantation of three COTS stents with high, intermediate, and low material densities.

Particle imaging velocimetry evaluation of intracranial stents in sidewall aneurysm: hemodynamic transition related to the stent design.

We investigated the flow modifications induced by a large panel of commercial-off-the-shelf (COTS) intracranial stents in an idealized sidewall intracranial aneurysm (IA). Flow velocities in IA silicone model were assessed with and without stent implantation using particle imaging velocimetry (PIV). The use of the recently developed multi-time-lag method has allowed for uniform and precise measurements of both high and low velocities at IA neck and dome, respectively.

Assessment of intra-aneurysmal flow modification after flow diverter stent placement with four-dimensional flow MRI: a feasibility study.

Background: Flow diverter stents (FDS) have been effectively used for the endovascular treatment of sidewall intracranial aneurysms (IAs). Unlike standard endovascular treatments used to exclude directly the aneurysm bulge from the parent vessel, FDS induce reduction in the intra-aneurysmal flow and promote progressive and stable thrombosis therein. The advent of FDS has therefore increased the need for understanding of IA hemodynamics.

Wall shear stress distribution of small aneurysms prone to rupture: a case-control study.

Background And Purpose: Subarachnoid hemorrhage after intracranial aneurysm rupture remains a serious condition. We performed a case-control study to evaluate the use of computed hemodynamics to detect cerebral aneurysms prone to rupture.

Methods: Four patients with incidental aneurysms that ultimately ruptured (cases) were studied after initially being included in a prospective database including their 3-dimensional imaging before rupture.

Biology and hemodynamics of aneurismal vasculopathies.

Aneurysm vasculopathies represents a group of vascular disorders that share a common morphological diagnosis: a vascular dilation, the aneurysm. They can have a same etiology and a different clinical presentation or morphology, or have different etiology and very similar anatomical geometry. The biology of the aneurysm formation is a complex process that will be a result of an endogenous predisposition and epigenetic factors later on including the intracranial hemodynamics.

Quantification of arterial flow using digital subtraction angiography.

Purpose: In this paper, a method for the estimation of arterial hemodynamic flow from x-ray video densitometry data is proposed and validated using an in vitro setup.

Methods: The method is based on the acquisition of three-dimensional rotational angiography and digital subtraction angiography sequences. A modest contrast injection rate (between 1 and 4 ml/s) leads to a contrast density that is modulated by the cardiac cycle, which can be measured in the x-ray signal.

Combined use of pulsed arterial spin-labeling and susceptibility-weighted imaging in stroke at 3T.

Background And Purpose: In acute stroke it is no longer sufficient to detect simply ischemia, but also to try to evaluate reperfusion/recanalization status and predict eventual hemorrhagic transformation. Arterial spin labeling (ASL) perfusion may have advantages over contrast-enhanced perfusion-weighted imaging (cePWI), and susceptibility weighted imaging (SWI) has an intrinsic sensitivity to paramagnetic effects in addition to its ability to detect small areas of bleeding and hemorrhage. We want to determine here if their combined use in acute stroke and stroke follow-up at 3T could bring new insight into the diagnosis and prognosis of stroke leading to eventual improved patient management.

Lattice-gas cellular automaton models for biology: from fluids to cells.

Lattice-gas cellular automaton (LGCA) and lattice Boltzmann (LB) models are promising models for studying emergent behaviour of transport and interaction processes in biological systems. In this chapter, we will emphasise the use of LGCA/LB models and the derivation and analysis of LGCA models ranging from the classical example dynamics of fluid flow to clotting phenomena in cerebral aneurysms and the invasion of tumour cells.

Treatment of renal artery aneurysm with the multilayer stent.

Purpose: To describe a new type of stent consisting of a 3-dimensional (3D) braided tube made of 2 interconnected layers without any covering to treat a renal artery aneurysm.

Case Report: A 78-year-old hypertensive man with multiple comorbidities was incidentally found to have a large (28- x 30 mm) saccular aneurysm in the main right renal artery involving the inferior renal artery. Via a percutaneous femoral approach, a 6- x 30-mm Multilayer stent was deployed easily in front of the aneurysm neck covering the inferior renal artery.