1,720,962 research outputs found
Understanding the role of hemodynamics in the initiation, progression, rupture, and treatment outcome of cerebral aneurysm from medical iamge-based computational studies
Get PDFAbout a decade ago, the first image-based computational hemodynamic studies of cerebral aneurysms were presented. Their potential for clinical applications was the results of a right combination of medical image processing, vascular reconstruction, and grid generation techniques used to reconstruct personalziaed domains for computational fluid and solid dynamics solvers and data analysis and visualization techniques. A considerable number of studies have captivated the attention of clinicians, neurosurgeons, and neuroradiologists, who realized the ability of those tools to help in understanding the role played by hemodynamics in the natural history and management of intracranial aneurysms. This paper intends to summarize the most relevant results in the filed reported during the last years.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin
Unsteady wall shear stress analysis from image-based computational fluid dynamic aneurysm models under Newtonian and Casson rheological models
Get PDFThe aim of this work was to determine whether or not Newtonian rheology assumption in image-based patient-specific computational fluid dynamics (CFD) cerebrovascular models harboring cerebral aneurysms may affect the hemodynamics characteristics, which have been previously associated with aneurysm progression and rupture. Ten patients with cerebral aneurysms with lobulations were considered. CFD models were reconstructed from 3DRA and 4DCTA images by means of region growing, deformable models, and an advancing front technique. Patient-specific FEM blood flow simulations were performed under Newtonian and Casson rheological models. Wall shear stress (WSS) maps were created and distributions were compared at the end diastole. Regions of lower WSS (lobulation) and higher WSS (neck) were identified. WSS changes in time were analyzed. Maximum, minimum and time-averaged values were calculated and statistically compared. WSS characterization remained unchanged. At high WSS regions, Casson rheology systematically produced higher WSS minimum, maximum and time-averaged values. However, those differences were not statistically significant. At low WSS regions, when averaging over all cases, the Casson model produced higher stresses, although in some cases the Newtonian model did. However, those differences were not significant either. There is no evidence that Newtonian model overestimates WSS. Differences are not statistically significant.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Olivares, María C. Ahumada. Universidad Favaloro; ArgentinaFil: Putman, Christopher M.. Texas Neurointerventional Surgery Associates; Estados UnidosFil: Cebral, Juan R.. George Mason University; Estados Unido
Hemodynamic characteristics at anterior communicating artery before aneurysm initiation using patient-specific finite element blood flow simulations
Get PDFThe anterior communicating artery (AComA) is a unique vascular location that receives blood from two sources of inflow and redistributes it toward the anterior part of the brain through two efferent arteries. It is widely accepted that complexity in the flow pattern is associated with the high rate of aneurysm formation in that location observed in large studies. A previous computational hemodynamic study showed a possible association between high maximum intraaneurysmal wall shear stress (WSS) at the systolic peak with rupture in a cohort of AComA aneurysms. In another study it was observed a connection between location of aneurysm blebs and regions of high WSS in models where blebs were virtually removed. The purpose of this work is to study associations between hemodynamic patterns and AComA aneurysm initiation by comparing hemodynamics between the aneurysm models and the normal model where the aneurysm was computationally removed. Vascular models of both right and left circulation were independently reconstructed from three-dimensional rotational angiography images using deformable models after image registration of both images, and later fused using a surface merging algorithm. Afterwards, the geometric models were used to generate high-quality volumetric finite element grids composed several million tetrahedral elements with an advancing front technique. For each patient the second anatomical model was created by digitally removing the aneurysm. It was iteratively achieved by applying a Laplacian smoothing filter and remeshing the surface. Finite element blood flow numerical simulations were performed for both the pathological and normal models under the same flow conditions. Personalized pulsatile flow conditions were imposed at the inlets of both models with use of the Womersley solution. The Navier-Stokes equations were numerically integrated by using a fully implicit finite-element formulation. From analysis of WSS distributions it was observed that aneurysms initiated in regions of high and moderate WSS in the counterpart normal models. Adjacent or close to those regions, low WSS portions of the arterial wall were not affected by the disease. These results are in line with previous reported observations at other vascular locations.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. George Mason University; Estados UnidosFil: Putman, Christopher M.. Inova Fairfax Hospital; Estados UnidosFil: Cebral, Juan Raúl. George Mason University; Estados Unido
Hemodynamic characteristics at anterior communicating artery before aneurysm initiation using patient-specific finite element blood flow simulations
Get PDFThe anterior communicating artery (AComA) is a unique vascular location that receives blood from two sources of inflow and redistributes it toward the anterior part of the brain through two efferent arteries. It is widely accepted that complexity in the flow pattern is associated with the high rate of aneurysm formation in that location observed in large studies. A previous computational hemodynamic study showed a possible association between high maximum intraaneurysmal wall shear stress (WSS) at the systolic peak with rupture in a cohort of AComA aneurysms. In another study it was observed a connection between location of aneurysm blebs and regions of high WSS in models where blebs were virtually removed. The purpose of this work is to study associations between hemodynamic patterns and AComA aneurysm initiation by comparing hemodynamics between the aneurysm models and the normal model where the aneurysm was computationally removed. Vascular models of both right and left circulation were independently reconstructed from three-dimensional rotational angiography images using deformable models after image registration of both images, and later fused using a surface merging algorithm. Afterwards, the geometric models were used to generate high-quality volumetric finite element grids composed several million tetrahedral elements with an advancing front technique. For each patient the second anatomical model was created by digitally removing the aneurysm. It was iteratively achieved by applying a Laplacian smoothing filter and remeshing the surface. Finite element blood flow numerical simulations were performed for both the pathological and normal models under the same flow conditions. Personalized pulsatile flow conditions were imposed at the inlets of both models with use of the Womersley solution. The Navier-Stokes equations were numerically integrated by using a fully implicit finite-element formulation. From analysis of WSS distributions it was observed that aneurysms initiated in regions of high and moderate WSS in the counterpart normal models. Adjacent or close to those regions, low WSS portions of the arterial wall were not affected by the disease. These results are in line with previous reported observations at other vascular locations.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. George Mason University; Estados UnidosFil: Putman, Christopher M.. Inova Fairfax Hospital; Estados UnidosFil: Cebral, Juan Raúl. George Mason University; Estados Unido
Effects of Casson rheology on aneurysm wall shear stress
Get PDFIt is widely accepted that wall shear stress plays an important role in cerebral aneurysm initiation, progress and rupture. Previous works have shown strong evidence in support of the high wall shear stress as a risk factor associated to those biomechanical processes. Patient-specific imagebased computational hemodynamic modeling of vascular systems harboring cerebral aneurysms has demonstrated to be a fast and reliable way to compute quantities difficult or impossible to be measured in-vivo. The accuracy of the simulation results have been successfully validated in the past. Additionally, most model assumptions have shown no impact on the flow characterization whose association with the mentioned processes was investigated. Particularly, the incorporation of the blood rheology in large arterial systems containing aneurysms resulted in similar hemodynamic characterizations for most aneurysms. However, large aneurysms, especially those containing blebs are expected to have flow rates in the range where Newtonian and non-Newtonian models exhibit the largest differences. In order to study the impact of blood rheology in vascular systems harboring specific intracranial aneurysms, unsteady finite element blood flow simulations were carried out over patient-specific models. Those models were reconstructed from rotational angiographic images using region growing and deformable model algorithms. Unstructured finite element meshes were generated using and advancing front technique. Walls were assumed as rigid, traction-free boundary conditions were imposed at the outlets of the models, and a flow rate wave form was imposed at the inlets after scaling according to the Murray's Law for optimal arterial networks. The Casson model was incorporated as a velocity gradient dependent apparent viscosity and the results were compared to those using the Newtonian rheology. Regions with differentiated wall shear stress values and orientations were studied.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Secretaria de Ciencia y Técnica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ahumada, Maria Carolina. Universidad Favaloro. Facultad de Ingeniería y Ciencias Exactas y Naturales; ArgentinaFil: Putman, Christopher M.. Innova Fairfax Hospital; Estados UnidosFil: Cebral, Juan Raúl. George Mason University; Estados Unido
Effects of Casson rheology on aneurysm wall shear stress
Get PDFIt is widely accepted that wall shear stress plays an important role in cerebral aneurysm initiation, progress and rupture. Previous works have shown strong evidence in support of the high wall shear stress as a risk factor associated to those biomechanical processes. Patient-specific imagebased computational hemodynamic modeling of vascular systems harboring cerebral aneurysms has demonstrated to be a fast and reliable way to compute quantities difficult or impossible to be measured in-vivo. The accuracy of the simulation results have been successfully validated in the past. Additionally, most model assumptions have shown no impact on the flow characterization whose association with the mentioned processes was investigated. Particularly, the incorporation of the blood rheology in large arterial systems containing aneurysms resulted in similar hemodynamic characterizations for most aneurysms. However, large aneurysms, especially those containing blebs are expected to have flow rates in the range where Newtonian and non-Newtonian models exhibit the largest differences. In order to study the impact of blood rheology in vascular systems harboring specific intracranial aneurysms, unsteady finite element blood flow simulations were carried out over patient-specific models. Those models were reconstructed from rotational angiographic images using region growing and deformable model algorithms. Unstructured finite element meshes were generated using and advancing front technique. Walls were assumed as rigid, traction-free boundary conditions were imposed at the outlets of the models, and a flow rate wave form was imposed at the inlets after scaling according to the Murray's Law for optimal arterial networks. The Casson model was incorporated as a velocity gradient dependent apparent viscosity and the results were compared to those using the Newtonian rheology. Regions with differentiated wall shear stress values and orientations were studied.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Secretaria de Ciencia y Técnica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ahumada, Maria Carolina. Universidad Favaloro. Facultad de Ingeniería y Ciencias Exactas y Naturales; ArgentinaFil: Putman, Christopher M.. Innova Fairfax Hospital; Estados UnidosFil: Cebral, Juan Raúl. George Mason University; Estados Unido
Estimation of Aneurysm Wall Motion from 4D Computerized Tomographic Angiography Images
Get PDFIt is widely accepted that wall shear stressis associated to aneurysm formation, growthand rupture. Early identification of potential risk factors may contribute to decide the treatment and improve patient care. Previous studies have shown associations between high aneurysm wall shear stress values and both elevated risk of rupture and localization of regions of aneurysm progression. Based on the assumption that damaged regions of the endothelium have different mechanical properties, regions with differentiated wall displacement amplitudes are expected. A previous approach based on the analysis ofbidimensional dynamic tomographic angiography images at a limited number of points during the cardiac cycle showed only small displacements in some patients using that simplified and semi-automatic low resolution methodology. The purpose of this work is to overcome some of those limitations. High time and spatial resolution four dimensional computerized tomographic angiography images of cerebral aneurysms were acquired and analyzed in order to identify and characterize wall motion. Images were filtered andsegmented at nineteentime points during the cardiac cycle.An average image was computed to generate the vascular model. Anunstructured mesh of tetrahedral elements was generated using an advancing front technique. A finite element blood flow simulationwas carried out under personalized pulsatile flow conditions. A fuzzy c-means clustering algorithm was used to estimate regions that exhibit wall motion within the aneurysm sac. A good correlation between localization of regions of elevated wall shear stress and regionsexhibiting wall motion was found.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ahumada Olivares, María C.. Universidad Favaloro; ArgentinaFil: Putman, Christopher M. . Inova Fairfax Hospital. Department of Interventional Neuroradiology; Estados UnidosFil: Cebral, Juan R.. George Mason University. Department of Computational and Data Sciences; Estados Unido
Effects of Stenotic Plaques in Realistic Carotid Artery Aneurysm Models: a CFD Study
Get PDFCerebral aneurysms may rarely coexist with a proximal artery stenosis. In that small percent of patients, such coexistence poses a challenge for interventional neuroradiologists and neurosurgeons to make the best treatment decision. According to previous studies, the incidence of cerebral aneurysms in patients with internal carotid artery stenosis is not greater than 5%, where the aneurysm is usually incidentally detected, being 2% for aneurysms and stenoses in the same cerebral circulation. Those cases pose a difficult management decision for the physician. Case reports showed patients who died due to aneurysm rupture months after endarterectomy but before aneurysm clipping, while others did not show any change in the aneurysm after plaque removal, having optimum outcome after aneurysm coiling. The aim of this study is to investigate the intraaneurysmal hemodynamic changes before and after treatment of stenotic plaque. Virtually created moderate stenoses in vascular models of internal carotid artery aneurysm patients were considered in a number of cases reconstructed from three dimensional rotational angiography images. The strategy to create those plaques was based on parameters analyzed in a previous work where idealized models were considered, including relative distance and stenosis grade. Ipsilateral and contralateral plaques were modeled. Wall shear stress and velocity pattern were computed from finite element pulsatile blood flow simulations. The results may suggest that relative angular position may change the wall shear stress within the aneurysm sac.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. George Mason University; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Peloc, Nora Luz. Universidad Favaloro; ArgentinaFil: Putman, Christopher M.. Inova Fairfax Hospital; Estados UnidosFil: Cebral, Juan Raúl. George Mason University; Estados Unido
Changes in cerebral aneurysm hemodynamics after virtual endarterectomy
Get PDFCerebral aneurysm hemodynamics depends on flow conditions at and geometry of parents vessels. Wall shear stress distributions and extreme values are widely accepted to be responsible for aneurysm initiation, growth and rupture. Those aneurysms may coexist with a proximal artery stenosis in a small number of patients. In those cases, that poses a challenge for interventional neuroradiologists and neurosurgeons to make the best treatment decision. For low and mild stenoses, flow alterations in the aneurysm sacs are limited when the aneurysms is located far downstream in the same circulation. However, for distal aneurysms close to the stenosis, intra-aneurysmal hemodynamics may be significantly affected by the stenosis. In this work we studied the changes in the wall shear stress distributions after virtual intervention in both ideal and patient-specific models. Three-dimensional rotational angiographic images were segmented using region growing and deformable model algorithms. Isosurface of the boundary was used to generate a volumetric mesh of tetrahedra in the domain using an advancing front technique. Numerical integration of the Navier-Stoke's equations was performed using a time dependent finite element formulation. Personalized inflow wave forms were imposed at the inlets and hemodynamic forces were studied at the systolic peak. Wall shear stress difference between and after virtual intervention were computed for different stenosis grades and different aneurysm locations.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires. Secretaria de Ciencia y Técnica; Argentina. George Mason University; Estados UnidosFil: Peloc, Nora Luz. Universidad Favaloro. Facultad de Ingeniería y Ciencias Exactas y Naturales; ArgentinaFil: Putman, Christopher M.. Innova Fairfax Hospital; Estados UnidosFil: Cebral, Juan Raúl. George Mason University; Estados Unido
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