Intra-aneurysmal Velocity Research Articles

A multidimensional pre-operative planning method of unruptured vertebral artery dissecting aneurysms using three-dimensional AWE mapping and hemodynamic simulation

ObjectiveHigh-resolution magnetic resonance imaging (HR-MRI) can provide valuable insights into the evaluation of vascular pathological conditions, and 3D digital subtraction angiography (3D-DSA) offers clear visualization of the vascular morphology and hemodynamics. This study aimed to investigate the potential of a multimodal method to treat unruptured vertebral artery dissection aneurysms (u-VADAs) by fusing image data from HR-MRI and 3D-DSA. MethodsThis observational study enrolled 5 patients diagnosed with u-VADAs, who were scheduled for interventional treatment. The image data of HR-MRI and 3D-DSA were merged by geometry software, resulting in a multimodal model. Quantified values of aneurysm wall enhancement (AWE), wall shear stress (WSS), neck velocity, inflow volume, intra-stent flow velocity (ISvelocity), and intra-aneurysmal velocity (IAvelocity) were calculated from the multimodal method. ResultsWe found the actual lengths of u-VADAs in the multimodal model were longer than the 3D-DSA model. We formulated surgical plannings based on the WSS, IA velocity, and neck velocity. The post-operative value of IAvelocity, neck velocity, and follow-up quantified values of AWE were decreased compared with the pre-operative condition. After that, u-VADAs were complete occlusion in four patients and near-complete occlusion in one patient during the 6th-month follow-up after surgery. ConclusionThe multidimensional method combining HR-MRI with 3D-DSA may provide more valuable information for treating VADAs, with the potential to develop effective surgical planning.

Endovascular Treatment of Intracranial Aneurysm: The Importance of the Rheological Model in Blood Flow Simulations.

Hemodynamics in intracranial aneurysm strongly depends on the non-Newtonian blood behavior due to the large number of suspended cells and the ability of red blood cells to deform and aggregate. However, most numerical investigations on intracranial hemodynamics adopt the Newtonian hypothesis to model blood flow and predict aneurysm occlusion. The aim of this study was to analyze the effect of the blood rheological model on the hemodynamics of intracranial aneurysms in the presence or absence of endovascular treatment. A numerical investigation was performed under pulsatile flow conditions in a patient-specific aneurysm with and without the insertion of an appropriately reconstructed flow diverter stent (FDS). The numerical simulations were performed using Newtonian and non-Newtonian assumptions for blood rheology. In all cases, FDS placement reduced the intra-aneurysmal velocity and increased the relative residence time (RRT) on the aneurysmal wall, indicating progressive thrombus formation and aneurysm occlusion. However, the Newtonian model largely overestimated RRT values and consequent aneurysm healing with respect to the non-Newtonian models. Due to the non-Newtonian blood properties and the large discrepancy between Newtonian and non-Newtonian simulations, the Newtonian hypothesis should not be used in the study of the hemodynamics of intracranial aneurysm, especially in the presence of endovascular treatment.

Hemodynamics of aneurysm intervention with different stents

An ideal cerebral aneurysm model with different stent forms is established. By using the single-relaxation-time (SRT) lattice Boltzmann method (LBM) to solve the flow field, the blood flow characteristics in the aneurysm under different conditions are studied numerically. The intra-arterial stenting of saccular aneurysms at different Reynolds numbers and the feasibility of new stenting forms such as double stenting and variable-spacing stenting in the aneurysms are explored. The hemodynamic factors such as velocity distribution and wall shear stress (WSS) in the aneurysm are analyzed. Numerical results show that the risk of aneurysm rupture is mainly centralized at the right corner of the aneurysm. Intervention of stents in the aneurysm can effectively reduce the intra-aneurysmal velocity and WSS, and decrease the danger of aneurysm rupture during strenuous exercise or emotional excitement. At the same time, the intervention of a double stent and the stent shape with a dense anterior part in the aneurysm has certain advantages in preventing aneurysm rupture. The intra-aneurysmal mean velocity reduction can reach 90.39% and 80.29% after the intervention of the double stent and the anterior densified stent respectively.

The Hemodynamics of Aneurysms Treated with Flow-Diverting Stents Considering both Stent and Aneurysm/Artery Geometries

Flow diverting stents are deployed to reduce the blood flow into the aneurysm, which would thereby induce thrombosis in the aneurysm sac; the stents prevent its rupture. The present study aimed to examine and quantify the impacts of different flow stents on idealized configurations of the cerebral artery. In our study, we considered a spherical sidewall aneurysm located on curved and tortuous idealized artery vessels and three stents with different porosities (70, 80 and 90%) for deployment. Using computational fluid dynamics, the local hemodynamics in the presence and absence of the stents were simulated, respectively, under the assumption that the blood flow was unsteady and non-Newtonian. The hemodynamic parameters, such as the intra-aneurysmal flow, velocity field and wall shear stress and its related indices, were examined and compared among the 12 cases simulated. The results illustrated that with the stent deployment, the intra-aneurysmal flow and the wall shear stress and its related indices were considerably modified depending on both stent and aneurysm/artery geometries, and that the intra-aneurysmal relative residence time increased rapidly with decreasing stent porosity in all the vessel configurations. These results also inform the rationale for selecting stents for treating aneurysms of different configurations.

Synchrotron speckle-based x-ray phase-contrast imaging for mapping intra-aneurysmal blood flow without contrast agent

Intracranial aneurysms carry risk of rupture with life threatening consequences. Hemodynamic forces are considered to be the key in cerebral aneurysm rupture. Notably, the hemodynamic analysis requires precise characterization of intra-aneurysmal blood velocity field, raising the need to develop novel measurement techniques. This study aims to assess the performance of speckle-based x-ray phase contrast particle imaging velocimetry (PIV) for velocity field mapping of a pulsatile blood flow in a patient specific aneurysm model without contrast agent. Porcine blood was used in a blood circulation loop including the aneurysm model, which was imaged using the synchrotron x-ray phase contrast imaging (PCI) at an optimum phase propagation distance. X-ray images were processed to improve speckle characteristics for PIV analysis. A computational fluid dynamic (CFD) model was developed for simulation of the blood velocity field and compared to the x-ray PCI-PIV measurements. The CFD model and x-ray PCI-PIV measurements showed similar intra-aneurysmal blood flow structures although the velocity magnitudes were generally higher in CFD model. Contrary to CFD model, x-ray PCI-PIV measurements revealed formation of blood cell stagnation at the aneurysm dome at low blood flow rate, cushioning upon the blood flow shear force. Synchrotron x-ray PCI-PIV offers potential for hemodynamic analysis in patient specific cerebral aneurysm models without contrast agent.

Four-Dimensional Phase Contrast Magnetic Resonance Imaging Protocol Optimization Using Patient-Specific 3-Dimensional Printed Replicas for InVivo Imaging Before and After Flow Diverter Placement.

Hemodynamics in cerebral aneurysms are currently investigated toward clinical efficacy using nonstandardized computational simulation techniques. At the same time, flow patterns and velocities are accessible by 4-dimensional phase contrast magnetic resonance imaging (4D pcMRI). Complexity of protocol design and imaging duration has limited the use of this technique in clinical imaging. A new approach is presented to overcome these limitations. Three-dimensional (3D) replicas of 2 cerebral aneurysms were fabricated by fused deposition prototyping (3D printing) and imaged using 4D pcMRI while connected to a magnetic resonance imaging-compatible continuous flow loop. Acquisition parameters were optimized with imaging times not to exceed 10 minutes. Six patients harboring cerebral aneurysms with sizes ranging from 4.7 to 13.8 mm were imaged with the optimized 4D pcMRI protocol. After treatment with the pipeline embolization device (PED), 4D pcMRI examinations were repeated in 3 patients. In all cases, major flow patterns were visualized well; smaller aneurysms posed a challenge because of limited spatial resolution, whereas larger aneurysms contained regions of low velocity resulting in limited contrast in the flow-sensitive images. After PED placement, ordered aneurysmal flow was disrupted and intra-aneurysmal velocity was reduced on average by 24.5% (range, 12.9-31.5%). Exploratory statistical analysis yielded a positive significant correlation (P < 0.01) between changes in inflow velocity and posttreatment intra-aneurysmal flow velocity. 4D pcMRI flow imaging in cerebral aneurysms within a time frame suitable for clinical imaging applications is feasible with optimized acquisition parameters, thereby enabling quantification of intra-aneurysmal flow changes after flow diverter device treatment.

Towards the patient-specific design of flow diverters made from helix-like wires: an optimization study.

BackgroundFlow diverter (FD) intervention is an emerging endovascular technique for treating intracranial aneurysms. High flow-diversion efficiency is desired to accelerate thrombotic occlusion inside the aneurysm; however, the risk of post-stenting stenosis in the parent artery is posed when flow-diversion efficiency is pursued by simply decreasing device porosity. For improving the prognosis of FD intervention, we develop an optimization method for the design of patient-specific FD devices that maintain high levels of porosity.MethodsAn automated structure optimization method for FDs with helix-like wires was developed by applying a combination of lattice Boltzmann fluid simulation and simulated annealing procedure. Employing intra-aneurysmal average velocity as the objective function, the proposed method tailored the wire structure of an FD to a given vascular geometry by rearranging the starting phase of the helix wires.ResultsFD optimization was applied to two idealized (S and C) vascular models and one realistic (R) model. Without altering the original device porosity of 80%, the flow-reduction rates of optimized FDs were improved by 5, 2, and 28% for the S, C, and R models, respectively. Furthermore, the aneurysmal flow patterns after optimization exhibited marked alterations. We confirmed that the disruption of bundle of inflow is of great help in blocking aneurysmal inflow. Axial displacement tests suggested that the optimal FD implanted in the R model possesses good robustness to tolerate uncertain axial positioning errors.ConclusionsThe optimization method developed in this study can be used to identify the FD wire structure with the optimal flow-diversion efficiency. For a given vascular geometry, custom-designed FD structure can maximally reduce the aneurysmal inflow with its porosity maintained at a high level, thereby lowering the risk of post-stenting stenosis. This method facilitates the study of patient-specific designs for FD devices.

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

Our aim was to assess the performance of flow-diverter stents. The pre- and end-of-treatment angiographies are commonly compared. However, the arterial flow rate may change between acquisitions; therefore, a better understanding of its influence on the local intra-aneurysmal hemodynamics before and after flow-diverter stent use is required. Twenty-five image-based aneurysm models extracted from 3D rotational angiograms were conditioned for computational fluid dynamics simulations. Pulsatile simulations were performed at different arterial flow rates, covering a wide possible range of physiologic flows among 1-5 mL/s. The effect of flow-diverter stents on intra-aneurysmal hemodynamics was numerically simulated with a porous medium model. Spatiotemporal-averaged intra-aneurysmal flow velocity and flow rate were calculated for each case to quantify the hemodynamics after treatment. The short-term flow-diverter stent performance was characterized by the relative velocity reduction inside the aneurysm. Spatiotemporal-averaged intra-aneurysmal flow velocity before and after flow-diverter stent use is linearly proportional to the mean arterial flow rate (minimum R2 > 0.983 of the linear regression models for untreated and stented models). Relative velocity reduction asymptotically decreases with increasing mean arterial flow rate. When the most probable range of arterial flow rate was considered (3-5 mL/s), instead of the wide possible flow range, the mean SD of relative velocity reduction was reduced from 3.6% to 0.48%. Both intra-aneurysmal aneurysm velocity and flow-diverter stent performance depend on the arterial flow rate. The performance could be considered independent of the arterial flow rates within the most probable range of physiologic flows.

Evaluation of intra-aneurysmal hemodynamics after flow diverter placement in a patient-specific aneurysm model.

The growth and rupture of cerebral aneurysms is intrinsically related to the hemodynamics prevailing in the diseased area. Therefore, a better understanding of intra-aneurysmal hemodynamics is essential for developing effective treatment methods. The intention of this study was to evaluate the intra-aneurysmal flow and flow reduction induced by flow diverters in a true-to-scale elastic aneurysm model, obtained from real patient data. Based on the computed tomography angiography (CTA) data of a fusiform aneurysm of a 34 year old patient, an elastic silicon rubber model of the aneurysm was produced. A physiologic pulsatile flow was created with a circulatory experimental set-up, and a non-Newtonian perfusion fluid was used as a substitute for human blood. Hemodynamics were measured by LDA before and after flow diverter implantation. Implantation of a flow diverter device resulted in a reduction of intra-aneurysmal maximum flow velocities of 97.8% at the inflow zone, 89.1% in the dome and 89.3% at the outflow zone, when compared to the native model. A significant reduction of 94% in the mean intra-aneurysmal velocity was found. This promising methodology can optimize patient treatment and will correlate with computational simulations to evaluate their reliability.

Unraveling the relationship between arterial flow and intra-aneurysmal hemodynamics

Arterial flow rate affects intra-aneurysmal hemodynamics but it is not clear how their relationship is. This uncertainty hinders the comparison among studies, including clinical evaluations, like a pre- and post-treatment status, since arterial flow rates may differ at each time acquisition. The purposes of this work are as follows: (1) To study how intra-aneurysmal hemodynamics changes within the full physiological range of arterial flow rates. (2) To provide characteristic curves of intra-aneurysmal velocity, wall shear stress (WSS) and pressure as functions of the arterial flow rate. Fifteen image-based aneurysm models were studied using computational fluid dynamics (CFD) simulations. The full range of physiological arterial flow rates reported in the literature was covered by 11 pulsatile simulations. For each aneurysm, the spatiotemporal-averaged blood flow velocity, WSS and pressure were calculated. Spatiotemporal-averaged velocity inside the aneurysm linearly increases as a function of the mean arterial flow (minimum R2>0.963). Spatiotemporal-averaged WSS and pressure at the aneurysm wall can be represented by quadratic functions of the arterial flow rate (minimum R2>0.996). Quantitative characterizations of spatiotemporal-averaged velocity, WSS and pressure inside cerebral aneurysms can be obtained with respect to the arterial flow rate. These characteristic curves provide more information of the relationship between arterial flow and aneurysm hemodynamics since the full range of arterial flow rates is considered. Having these curves, it is possible to compare experimental studies and clinical evaluations when different flow conditions are used.

Математическое моделирование гемодинамики в индивидуализированной модели церебральной аневризмы

Cerebral aneurysm is one of the major diseases of cerebral arteries. The hemodynamics plays a key role in aneurysm growth and rupture while an individual morphology of the cerebral artery is the most important factor which influences the aneurysm hemodynamics. The patient-specific model of aneurysm was taken for the evaluation of the blood flow into the aneurysm region. The numerical mesh was created for domain which consisted of 2 million elements. Using the developed software complex a numerical simulation was performed for the time period of Т = 5 s. According to the numerical results the unstable vortex exists in the aneurysm region which could lead to thrombus formation. The maximum velocity – u = 1,27 m/s blood has at the inlet segment elbow while at the outlet segment a velocity does not exceed the 0,75 m/s. An intra-aneurysmal velocity magnitude varies from 4⋅10 to 0,5 m/s. The lowest value of wall shear stress was obtained in the aneurysm dome, which can be a cause of the future growing and rupture of the studied aneurysm. The presented method can be used for the evaluation of the aneurysm flow-pattern for clinical decision support process. Introduction. Cerebral aneurysm is one of the major diseases of cerebral arteries. According to the researchers [2 – 5] the hemodynamics plays a key role in aneurysm growth and rupture. Individual morphology of the cerebral artery is the most important factor which influences the aneurysm hemodynamics. The patient-specific evaluation of aneurysm hemodynamics is a promising method for investigation of intra-aneurysmal flow-pattern which helps the surgeon in decision making process on the pre-operational stage. Methods. The patient-specific model of aneurysm was taken for the evaluation of the blood flow into the aneurysm region (Fig. 1). A selected cerebral region has one inlet and two outlets. The size of the cerebral segment is 35.8 × 40 × 79 mm with an aneurysm sac of 11.2 × 11.4 × 14.1 mm. The inlet and outlet tubes have a diameter of 8 mm. * The reported study was supported by the Supercomputing Center of Lomonosov Moscow State University [1]. По материалам доклада на конференции «Актуальные проблемы энергосбережения и энергоэффективности в технических системах».

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

BackgroundFlow 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...

Hemodynamics in two tandem aneurysms treated with flow diverters

The purpose of this study was to investigate whether the occlusion time of cerebral aneurysms treated with flow diverters depends on the hemodynamic conditions created immediately after treatment. A case study of a pair of tandem intracranial aneurysms that were treated with flow-diverting devices and occluded at different times was carried out. A patient-specific computational fluid dynamics model was constructed from 3D rotational angiography images. Blood flow simulations were carried out under pulsatile physiologic conditions, and hemodynamic variables before and after deployment of the flow-diverting devices were quantified and compared. The flow-diverting devices reduced aneurysm inflow rates, intra-aneurysmal flow velocities, shear rates, and wall shear stresses. The flow patterns after flow modulation by the flow diverters were smoother and with less swirling. The reductions in hemodynamic quantities depended on the aneurysm and parent artery and were larger in the aneurysm that occluded faster. The results of this case study suggest that the larger the reduction in the hemodynamic variables considered, the shorter the time it takes for the aneurysm to thrombose. This result can help us better define the goal of these interventions.

Finite element modeling of embolic coil deployment: Multifactor characterization of treatment effects on cerebral aneurysm hemodynamics

Endovascular coiling is the most common treatment for cerebral aneurysms. During the treatment, a sequence of embolic coils with different stiffness, shapes, sizes, and lengths is deployed to fill the aneurysmal sac. Although coil packing density has been clinically correlated with treatment success, many studies have also reported success at low packing densities, as well as recurrence at high packing densities. Such reports indicate that other factors may influence treatment success. In this study, we used a novel finite element approach and computational fluid dynamics (CFD) to investigate the effects of packing density, coil shape, aneurysmal neck size, and parent vessel flow rate on aneurysmal hemodynamics. The study examines a testbed of 80 unique CFD simulations of post-treatment flows in idealized basilar tip aneurysm models. Simulated coil deployments were validated against in vitro and in vivo deployments. Among the investigated factors, packing density had the largest effect on intra-aneurysmal velocities. However, multifactor analysis of variance showed that coil shape can also have considerable effects, depending on packing density and neck size. Further, linear regression analysis showed an inverse relationship between mean void diameter in the aneurysm and mean intra-aneurysmal velocities, which underscores the importance of coil distribution and thus coil shape. Our study suggests that while packing density plays a key role in determining post-treatment hemodynamics, other factors such as coil shape, aneurysmal geometry, and parent vessel flow may also be very important.

Newtonian and non-Newtonian blood flow in coiled cerebral aneurysms

Endovascular coiling aims to isolate the aneurysm from blood circulation by altering hemodynamics inside the aneurysm and triggering blood coagulation. Computational fluid dynamics (CFD) techniques have the potential to predict the post-operative hemodynamics and to investigate the complex interaction between blood flow and coils. The purpose of this work is to study the influence of blood viscosity on hemodynamics in coiled aneurysms. Three image-based aneurysm models were used. Each case was virtually coiled with a packing density of around 30%. CFD simulations were performed in coiled and untreated aneurysm geometries using a Newtonian and a Non-Newtonian fluid models. Newtonian fluid slightly overestimates the intra-aneurysmal velocity inside the aneurysm before and after coiling. There were numerical differences between fluid models on velocity magnitudes in coiled simulations. Moreover, the non-Newtonian fluid model produces high viscosity (>0.007 [Pas]) at aneurysm fundus after coiling. Nonetheless, these local differences and high-viscous regions were not sufficient to alter the main flow patterns and velocity magnitudes before and after coiling. To evaluate the influence of coiling on intra-aneurysmal hemodynamics, the assumption of a Newtonian fluid can be used.

A Virtual Coiling Technique for Image-Based Aneurysm Models by Dynamic Path Planning

Computational algorithms modeling the insertion of endovascular devices, such as coil or stents, have gained an increasing interest in recent years. This scientific enthusiasm is due to the potential impact that these techniques have to support clinicians by understanding the intravascular hemodynamics and predicting treatment outcomes. In this work, a virtual coiling technique for treating image-based aneurysm models is proposed. A dynamic path planning was used to mimic the structure and distribution of coils inside aneurysm cavities, and to reach high packing densities, which is desirable by clinicians when treating with coils. Several tests were done to evaluate the performance on idealized and image-based aneurysm models. The proposed technique was validated using clinical information of real coiled aneurysms. The virtual coiling technique reproduces the macroscopic behavior of inserted coils and properly captures the densities, shapes and coil distributions inside aneurysm cavities. A practical application was performed by assessing the local hemodynamic after coiling using computational fluid dynamics (CFD). Wall shear stress and intra-aneurysmal velocities were reduced after coiling. Additionally, CFD simulations show that coils decrease the amount of contrast entering the aneurysm and increase its residence time.

Flow diversion treatment: intra-aneurismal blood flow velocity and WSS reduction are parameters to predict aneurysm thrombosis

To evaluate the haemodynamic changes induced by flow diversion treatment in cerebral aneurysms, resulting in thrombosis or persisting aneurysm patency over time. Eight patients with aneurysms at the para-ophthalmic segment of the internal carotid artery were treated by flow diversion only. The clinical follow-up ranged between 6 days and 12 months. Computational fluid dynamics (CFD) analysis of pre- and post-treatment conditions was performed in all cases. True geometric models of the flow diverter were created and placed over the neck of the aneurysms by using a virtual stent-deployment technique, and the device was simulated as a true physical barrier. Pre- and post-treatment haemodynamics were compared, including mean and maximal velocities, wall-shear stress (WSS) and intra-aneurysmal flow patterns. The CFD study results were then correlated to angiographic follow-up studies. Mean intra-aneurysmal flow velocities and WSS were significantly reduced in all aneurysms. Changes in flow patterns were recorded in only one case. Seven of eight aneurysms showed complete occlusion during the follow-up. One aneurysm remaining patent after 1 year showed no change in flow patterns. One aneurysm rupturing 5 days after treatment showed also no change in flow pattern, and no change in the maximal inflow velocity. Relative flow velocity and WSS reduction in and of itself may result in aneurysm thrombosis in the majority of cases. Flow reductions under aneurysm-specific thresholds may, however, be the reason why some aneurysms remain completely or partially patent after flow diversion.

Exploring High Frequency Temporal Fluctuations in the Terminal Aneurysm of the Basilar Bifurcation

Cerebral aneurysms are a common cause of death and disability. Of all the cardiovascular diseases, aneurysms are perhaps the most strongly linked with the local fluid mechanic environment. Aside from early in vivo clinical work that hinted at the possibility of high-frequency intra-aneurysmal velocity oscillations, flow in cerebral aneurysms is most often assumed to be laminar. This work investigates, through the use of numerical simulations, the potential for disturbed flow to exist in the terminal aneurysm of the basilar bifurcation. The nature of the disturbed flow is explored using a series of four idealized basilar tip models, and the results supported by four patient specific terminal basilar tip aneurysms. All four idealized models demonstrated instability in the inflow jet through high frequency fluctuations in the velocity and the pressure at approximately 120 Hz. The instability arises through a breakdown of the inflow jet, which begins to oscillate upon entering the aneurysm. The wall shear stress undergoes similar high-frequency oscillations in both magnitude and direction. The neck and dome regions of the aneurysm present 180 deg changes in the direction of the wall shear stress, due to the formation of small recirculation zones near the shear layer of the jet (at the frequency of the inflow jet oscillation) and the oscillation of the impingement zone on the dome of the aneurysm, respectively. Similar results were observed in the patient-specific models, which showed high frequency fluctuations at approximately 112 Hz in two of the four models and oscillations in the magnitude and direction of the wall shear stress. These results demonstrate that there is potential for disturbed laminar unsteady flow in the terminal aneurysm of the basilar bifurcation. The instabilities appear similar to the first instability mode of a free round jet.

Hemodynamics and Rupture of Terminal Cerebral Aneurysms

The objective of this study was to investigate the relationship between hemodynamics patterns and aneurysmal rupture in cerebral aneurysms of the same morphology regardless their location. Particularly, terminal aneurysms in both the anterior and posterior circulation were studied. A total of 42 patient-specific vascular models were constructed from three-dimensional rotational angiography images. All patients had terminal aneurysms at different arteries: a) middle cerebral; b) anterior communicating; c) internal carotid (terminus); d) internal carotid-posterior communicating; e) basilar; or f) anterior cerebral. Hemodynamics information (intra-aneurysmal velocity and wall shear stress distributions) was derived from image-based computational fluid dynamics models with realistic patient-specific anatomies. The group of aneurysms with an inflow jet that splits in two secondary jets, one of which enters the aneurysm before reaching one of the daughter vessels (type B), had the highest peak wall shear stress (WSS) and the highest rupture rate. The peak WSS averaged over each flow type showed a higher value in the ruptured group. The average peak WSS in the ruptured group (all types) was 188 dyn/cm(2) (compared to 118 dyn/cm(2) for the unruptured). This finding is in agreement with a previous work in which only anterior communicating artery aneurysms were investigated. The significance of these findings is that, if they are statistically confirmed with larger number of cases, flow types could be directly observed during angiographic examinations and linked to WSS categories that may help evaluate which aneurysms are more likely to rupture.

On automated analysis of flow patterns in cerebral aneurysms based on vortex identification

It is hypothesized that the risk of rupture of cerebral aneurysms is related to geometrical and mechanical properties of the arterial wall as well as to local hemodynamics. In order to gain better understanding of the hemodynamical factors involved in intra-aneurysmal flows, a thorough analysis of the 3D velocity field within an idealized geometry is needed. This includes the identification and quantification of features like vortices and stagnation regions. The aim of our research is to develop experimentally validated computational methods to analyse intra-aneurysmal vortex patterns and, eventually, define candidate hemodynamical parameters (e.g. vortex strength) that could be predictive for rupture risk. A computational model based on a standard Galerkin finite-element approximation and an Euler implicit time integration has been applied to compute the velocity field in an idealized aneurysm geometry and the results have been compared to Particle Image Velocimetry (PIV) measurements in an in vitro model. In order to analyze the vortices observed in the aneurysmal sac, the vortex identification scheme as proposed by Jeong and Hussain (JFM 285:69–94, 1995) is applied. The 3D intra-aneurysmal velocity fields reveal complex vortical structures. This study indicates that the computational method predicts well the vortex structure that is found in the in vitro model and that a 3D analysis method like the vortex identification as proposed is needed to fully understand and quantify the vortex dynamics of intra-aneurysmal flow. Furthermore, such an automated analysis method would allow the definition of parameters predictive for rupture in clinical practice.