A clinically aligned experimental approach for quantitative characterization of patient-specific cardiovascular models

Recent improvements in computational tools opened the possibility of patient-specific modeling to aid clinicians during diagnosis, treatment, and monitoring. One example is the modeling of blood flow for surgical planning, where modeling can help predict the prognosis. Computational analysis is used to extract hemodynamic information about the case; however, these methods are sensitive to assumptions on blood properties, boundary conditions, and appropriate geometry accuracy. When available, experimental measurements can be used to validate the results and, among the modalities, ultrasound-based methods are suitable due to their relative low cost and non-invasiveness. This work proposes a procedure to create accurate patient-specific silicone replicas of blood vessels and a power Doppler compatible experimental setup able to simulate and measure realistic flow conditions. The assessment of silicone model geometry shows small discrepancies between these and the target geometries (median of surface error lies within 57 µm and 82 μm). Power Doppler measurements were compared against computational fluid dynamics results, showing discrepancies within 10% near the wall. The experimental approach offers a setup to quantify flow in in vitro systems and provide more accurate results where other techniques (e.g., particle image velocimetry and particle tracking velocimetry) have shown limitations due to the interference of the interface

The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents

BACKGROUND AND PURPOSE: Treatment of intracranial bifurcation aneurysms with flow-diverter stents can lead to caliber changes of the distal vessels in a subacute phase. This study aims to evaluate whether local anatomy and flow disruption induced by flow-diverter stents are associated with vessel caliber changes in intracranial bifurcations. MATERIALS AND METHODS: Radiologic images and demographic data were acquired for 25 patients with bifurcation aneurysms treated with flow-diverter stents. Whisker plots and Mann-Whitney rank sum tests were used to evaluate if anatomic data and caliber changes could be linked. Symmetry/asymmetry were defined as diameter ratio 1 = symmetric and diameter ratio <1 = asymmetric. Computational fluid dynamics was performed on idealized and patient-specific anatomies to evaluate flow changes induced by flow-diverter stents in the jailed vessel. RESULTS: Statistical analysis identified a marked correspondence between asymmetric bifurcation and caliber change. Symmetry ratios were lower for cases showing narrowing or subacute occlusion (medium daughter vessel diameter ratio = 0.59) compared with cases with posttreatment caliber conservation (medium daughter vessel diameter ratio = 0.95). Computational fluid dynamics analysis in idealized and patient-specific anatomies showed that wall shear stress in the jailed vessel was more affected when flow-diverter stents were deployed in asymmetric bifurcations (diameter ratio <0.65) and less affected when deployed in symmetric anatomies (diameter ratio ∼1.00). CONCLUSIONS: Anatomic data analysis showed statistically significant correspondence between caliber changes and bifurcation asymmetry characterized by diameter ratio <0.7 (P < .001). Similarly, computational fluid dynamics results showed the highest impact on hemodynamics when flow-diverter stents are deployed in asymmetric bifurcations (diameter ratio <0.65) with noticeable changes on wall sheer stress fields. Further research and clinical validation are necessary to identify all elements involved in vessel caliber changes after flow-diverter stent procedures