Endovascular intervention using traditional neurovascular stents and densely braided flow diverters (FDs) have become the preferred treatment strategies for traditionally challenging intracranial aneurysms. Modeling stent and FD deployment in patient-specific aneurysms and its flow modification results prior to the actual intervention can potentially predict the patient outcome and treatment optimization. We present a clinically focused, streamlined virtual stenting workflow that efficiently simulates stent and FD treatment in patient-specific aneurysms based on expanding a simplex mesh structure. The simplex mesh is generated using an innovative vessel-specific initialization technique, which uses the patient's parent artery diameter to identify the initial position of the simplex mesh inside the artery. A novel adaptive expansion algorithm enables the acceleration of deployment process by adjusting the expansion forces based on the distance of the simplex mesh from the parent vessel. The virtual stenting workflow was tested by modeling the treatment of two patient-specific aneurysms using the Enterprise stent and the Pipeline Embolization Device (commercial FD). Both devices were deployed in the aneurysm models in a few seconds. Computational fluid dynamics analyses of pre- and post-treatment aneurysmal hemodynamics show flow reduction in the aneurysmal sac in treated aneurysms, with the FD diverting more flow than the Enterprise stent. The test results show that this workflow can rapidly simulate clinical deployment of stents and FDs, hence paving the way for its future clinical implementation.
基金:
National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [1R01 NS 091075-01]; National Science Foundation of ChinaNational Natural Science Foundation of China [81220108007, 81171079]
第一作者机构:[1]SUNY Buffalo, Dept Mech & Aerosp Engn, Univ Buffalo, Buffalo, NY USA;[2]SUNY Buffalo, Toshiba Stroke & Vasc Res Ctr, Univ Buffalo, Buffalo, NY USA;
通讯作者:
通讯机构:[1]SUNY Buffalo, Dept Mech & Aerosp Engn, Univ Buffalo, Buffalo, NY USA;[2]SUNY Buffalo, Toshiba Stroke & Vasc Res Ctr, Univ Buffalo, Buffalo, NY USA;[3]Capital Med Univ, Sch Biomed Engn, Beijing, Peoples R China;[5]SUNY Buffalo, Dept Neurosurg, Univ Buffalo, Buffalo, NY USA;[7]SUNY Buffalo, Dept Biomed Engn, Univ Buffalo, Buffalo, NY USA
推荐引用方式(GB/T 7714):
Paliwal Nikhil,Yu Hongyu,Xu Jinhui,et al.Virtual stenting workflow with vessel-specific initialization and adaptive expansion for neurovascular stents and flow diverters[J].COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING.2016,19(13):1423-1431.doi:10.1080/10255842.2016.1149573.
APA:
Paliwal, Nikhil,Yu, Hongyu,Xu, Jinhui,Xiang, Jianping,Siddiqui, Adnan H....&Meng, Hui.(2016).Virtual stenting workflow with vessel-specific initialization and adaptive expansion for neurovascular stents and flow diverters.COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING,19,(13)
MLA:
Paliwal, Nikhil,et al."Virtual stenting workflow with vessel-specific initialization and adaptive expansion for neurovascular stents and flow diverters".COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING 19..13(2016):1423-1431