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Cerebral aneurysms treated with flow-diverting stents: computational models with intravascular blood flow measurements. AJNR Am J Neuroradiol 2014 Jan;35(1):143-8

Date

07/23/2013

Pubmed ID

23868162

Pubmed Central ID

PMC3858573

DOI

10.3174/ajnr.A3624

Scopus ID

2-s2.0-84892767577 (requires institutional sign-in at Scopus site)   58 Citations

Abstract

BACKGROUND AND PURPOSE: Computational fluid dynamics modeling is useful in the study of the hemodynamic environment of cerebral aneurysms, but patient-specific measurements of boundary conditions, such as blood flow velocity and pressure, have not been previously applied to the study of flow-diverting stents. We integrated patient-specific intravascular blood flow velocity and pressure measurements into computational models of aneurysms before and after treatment with flow-diverting stents to determine stent effects on aneurysm hemodynamics.

MATERIALS AND METHODS: Blood flow velocity and pressure were measured in peri-aneurysmal locations by use of an intravascular dual-sensor pressure and Doppler velocity guidewire before and after flow-diverting stent treatment of 4 unruptured cerebral aneurysms. These measurements defined inflow and outflow boundary conditions for computational models. Intra-aneurysmal flow rates, wall shear stress, and wall shear stress gradient were calculated.

RESULTS: Measurements of inflow velocity and outflow pressure were successful in all 4 patients. Computational models incorporating these measurements demonstrated significant reductions in intra-aneurysmal wall shear stress and wall shear stress gradient and a trend in reduced intra-aneurysmal blood flow.

CONCLUSIONS: Integration of intravascular dual-sensor guidewire measurements of blood flow velocity and blood pressure provided patient-specific computational models of cerebral aneurysms. Aneurysm treatment with flow-diverting stents reduces blood flow and hemodynamic shear stress in the aneurysm dome.

Author List

Levitt MR, McGah PM, Aliseda A, Mourad PD, Nerva JD, Vaidya SS, Morton RP, Ghodke BV, Kim LJ

Author

John D. Nerva MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Blood Flow Velocity
Blood Pressure
Blood Vessel Prosthesis
Cerebral Arteries
Cerebrovascular Circulation
Computer Simulation
Equipment Failure Analysis
Female
Humans
Intracranial Aneurysm
Male
Models, Cardiovascular
Models, Neurological
Prosthesis Failure
Statistics as Topic
Stents
Treatment Outcome