Comparison of body‐fitted, embedded and immersed solutions of low Reynolds‐number 3‐D incompressible flows

The solutions obtained for low Reynolds‐number incompressible flows using the same flow solver and solution technique on body‐fitted, embedded surface and immersed body grids of similar size are compared. The cases considered are a sphere at Re  = 100 and an idealized stented aneurysm. It is found that the solutions using all these techniques converge to the same grid‐independent solution. On coarser grids, the effect of higher‐order boundary conditions is noticeable. Therefore, if the manual labor required to set up a body‐fitted domain is excessive (as is often the case for patient‐specific geometries with medical devices), and/or computing resources are plentiful, the embedded surface and immersed body approaches become very attractive options

Parabolic recovery of boundary gradients

A parabolic recovery procedure suited for shear stress and heat flux recovery on surfaces from linear element data is proposed. The information required consists of the usual unknowns at points, as well as gradients recovered at the points that are one layer away from the wall. The procedure has been in use for some time and has consistently delivered superior results as compared with the usual wall shear stress and heat flux obtained from linear finite element method shape functions

Simulation of intracranial aneurysm stenting: Techniques and challenges

Recently, there has been considerable interest in the use of stents as endovascular flow diverters for the treatment of intracranial aneurysms. Simulating this novel method of treatment is essential for understanding the intra-aneurysmal hemodynamics in order to design better stents and to personalize and optimize the endovascular stenting procedures. This paper describes a methodology based on unstructured embedded grids for patient-specific modeling of stented cerebral aneurysms, demonstrates how the methodology can be used to address specific clinical questions, and discusses remaining technical issues. In particular, simulations are presented on a number of patient-specific models constructed from medical images and using different stent designs and treatment alternatives. Preliminary sensitivity analyses with respect to stent positioning and truncation of the stent model are presented. The results show that these simulations provide useful and valuable information that can be used during the planning phase of endovascular stenting interventions for the treatment of intracranial aneurysms

Computational fluid dynamics of stented intracranial aneurysms using adaptive embedded unstructured grids

Recently, there has been increased interest in the use of stents as flow diverters in the endovascular treatment of cerebral aneurysms as an alternative to surgical clipping or endovascular embolization with coils. The aim of aneurysm stenting is to block the flow into the aneurysm in order to clot the blood inside the aneurysm and effectively isolate it from the circulation and prevent bleeding from the aneurysm. A hybrid meshing approach that combines body‐fitted grids for the vessels and adaptive embedded grids for the stents is proposed and analyzed. This strategy simplifies considerably the geometry modeling problem and allows accurate patient‐specific hemodynamic simulations with endovascular devices. This approach is compared with the traditional body‐fitted approach in the case of the flow around a circular cylinder at representative Reynolds number and an idealized aneurysm model with a stent. A novel technique to map different stent designs to a given patient‐specific anatomical model is presented. The methodology is demonstrated on a patient‐specific hemodynamic model of an aneurysm of the internal carotid artery constructed from a 3D rotational angiogram and stented with two different stent designs. The results show that the methodology can be successfully used to model patient‐specific anatomies with different stents thereby making it possible to explore different stent design

Image-based computational hemodynamics methods and their application for the analysis of blood flow past endovascular devices

Knowledge of the hemodynamic conditions in intracranial aneurysms before and after endovascular treatment is important to better understand the mechanisms responsible for aneurysm growth and rupture, and to optimize and personalize the therapies. Unfortunately, there are no reliable imaging techniques for in vivo quantification of blood flow patterns in cerebral aneurysms. Patient-specific, image-based computational models provide an attractive alternative since they can handle any vascular geometry and physiologic flow condition. However, computational modeling of the hemodynamics in cerebral aneurysms after their endovascular treatment is a challenging problem because of the high degree of geometric complexity required to represent and mesh the vascular anatomy and the endovascular devices simultaneously. This paper describes an image-based methodology for constructing patient-specific vascular computational fluid dynamics models and an adaptive grid embedding technique to simulate blood flows around endovascular devices. The methodology is illustrated with several examples ranging from idealized vascular models to patient-specific models of cerebral aneurysms after deployment of stents and coils. These techniques have the potential to be used to select the best therapeutic option for a particular individual and to optimize the design of endovascular devices on a patient-specific basis

Patient-specific modeling of intracranial aneurysmal stenting

Simulating blood flow around stents in intracranial aneurysms is important for designing better stents and to personalize and optimize endovascular stenting procedures in the treatment of these aneurysms. However, the main difficulty lies in the generation of acceptable computational grids inside the blood vessels and around the stents. In this paper, a hybrid method that combines body-fitted grid for the vessel walls and adaptive embedded grids for the stent is presented. Also an algorithm to map a particular stent to the parent vessel is described. These approaches tremendously simplify the simulation of blood flow past these devices. The methodology is evaluated with an idealized stented aneurysm under steady flow conditions and demonstrated in various patient-specific cases under physiologic pulsatile flow conditions. These examples show that the methodology can be used with ease in modeling any patient-specific anatomy and using different stent designs. This paves the way for using these techniques during the planning phase of endovascular stenting interventions, particularly for aneurysms that are difficult to treat with coils or by surgical clipping

Adaptive Embedded/Immersed Unstructured Grid Techniques

Embedded mesh, immersed body or fictitious domain techniques have been used for many years as a way to discretize geometrically complex domains with structured grids. The use of such techniques within adaptive, unstructured grid solvers is relatively recent. The combination of body-fitted functionality for some portion of the domain, together with embedded mesh or immersed body functionality for another portion of the domain offers great advantages, which are increasingly being exploited. The present paper reviews the methodologies pursued so far, addresses implementational issues and shows the possibilities such techniques offer

Image-based analysis of blood flow modification in stented aneurysms

Currently there is increased interest in the use of stents as flow diverters for the treatment of intracranial aneurysms, especially wide necked aneurysms that are difficult to treat by coil embolization or surgical clipping. This paper presents image-based patient-specific computational models of the hemodynamics in cerebral aneurysms before and after treatment with a stent alone, with the goal of better understanding the hemodynamic effects of these devices and their relation to the outcome of the procedures. Stenting of cerebral aneurysms is a feasible endovascular treatment option for aneurysms with wide necks that are difficult to treat with coils or by surgical clipping. However, this requires stents that are capable of substantially modifying the intra-aneurysmal flow pattern in order to cause thrombosis of the aneurysm. The results presented in this paper show that the studied stent was able to change significantly the hemodynamic characteristics of the aneurysm. In addition, it was shown that patient-specific computational models constructed from medical images are capable of realistically representing the in vivo hemodynamic characteristics observed during conventional angiography examinations before and after stenting. This indicates that these models can be used to better understand the effects of different stent designs and to predict the alteration in the hemodynamic pattern of a given aneurysm produced by a given flow diverter. This is important for improving current design of flow diverting devices and patient treatment plans