Accuracy of computational cerebral aneurysm hemodynamics using patient-specific endovascular measurements. Ann Biomed Eng 2014 Mar;42(3):503-14
Date
10/29/2013Pubmed ID
24162859Pubmed Central ID
PMC3941739DOI
10.1007/s10439-013-0930-3Scopus ID
2-s2.0-84898899983 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
Computational hemodynamic simulations of cerebral aneurysms have traditionally relied on stereotypical boundary conditions (such as blood flow velocity and blood pressure) derived from published values as patient-specific measurements are unavailable or difficult to collect. However, controversy persists over the necessity of incorporating such patient-specific conditions into computational analyses. We perform simulations using both endovascularly-derived patient-specific and typical literature-derived inflow and outflow boundary conditions. Detailed three-dimensional anatomical models of the cerebral vasculature are developed from rotational angiography data, and blood flow velocity and pressure are measured in situ by a dual-sensor pressure and velocity endovascular guidewire at multiple peri-aneurysmal locations in 10 unruptured cerebral aneurysms. These measurements are used to define inflow and outflow boundary conditions for computational hemodynamic models of the aneurysms. The additional in situ measurements which are not prescribed in the simulation are then used to assess the accuracy of the simulated flow velocity and pressure drop. Simulated velocities using patient-specific boundary conditions show good agreement with the guidewire measurements at measurement locations inside the domain, with no bias in the agreement and a random scatter of ≈25%. Simulated velocities using the simplified, literature-derived values show a systematic bias and over-predicted velocity by ≈30% with a random scatter of ≈40%. Computational hemodynamics using endovascularly measured patient-specific boundary conditions have the potential to improve treatment predictions as they provide more accurate and precise results of the aneurysmal hemodynamics than those based on commonly accepted reference values for boundary conditions.
Author List
McGah PM, Levitt MR, Barbour MC, Morton RP, Nerva JD, Mourad PD, Ghodke BV, Hallam DK, Sekhar LN, Kim LJ, Aliseda AAuthor
John D. Nerva MD Assistant Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Blood Flow Velocity
Cerebral Angiography
Cerebrovascular Circulation
Computer Simulation
Female
Humans
Intracranial Aneurysm
Male
Middle Aged
Models, Cardiovascular
