Aneurysm flow characteristics in realistic carotid artery aneurysm models induced by proximal virtual stenotic plaques: a computational hemodynamics study

Marcelo A. Castro; Nora L. Peloc; Aichi Chien; Ezequiel Goldberg; Christopher M. Putman; Juan R. Cebral

doi:10.1117/12.2078555

17 March 2015 Aneurysm flow characteristics in realistic carotid artery aneurysm models induced by proximal virtual stenotic plaques: a computational hemodynamics study

Marcelo A. Castro, Nora L. Peloc, Aichi Chien, Ezequiel Goldberg, Christopher M. Putman, Juan R. Cebral

Author Affiliations +

Proceedings Volume 9417, Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging; 941727 (2015) https://doi.org/10.1117/12.2078555
Event: SPIE Medical Imaging, 2015, Orlando, Florida, United States

Abstract

Cerebral aneurysms may rarely coexist with a proximal artery stenosis. In that small percent of patients, such coexistence poses a challenge for interventional neuroradiologists and neurosurgeons to make the best treatment decision. According to previous studies, the incidence of cerebral aneurysms in patients with internal carotid artery stenosis is no greater than five percent, where the aneurysm is usually incidentally detected, being about two percent for aneurysms and stenoses in the same cerebral circulation. Those cases pose a difficult management decision for the physician. Case reports showed patients who died due to aneurysm rupture months after endarterectomy but before aneurysm clipping, while others did not show any change in the aneurysm after plaque removal, having optimum outcome after aneurysm coiling. The aim of this study is to investigate the intra-aneurysmal hemodynamic changes before and after treatment of stenotic plaque. Virtually created moderate stenoses in vascular models of internal carotid artery aneurysm patients were considered in a number of cases reconstructed from three dimensional rotational angiography images. The strategy to create those plaques was based on parameters analyzed in a previous work where idealized models were considered, including relative distance and stenosis grade. Ipsilateral and contralateral plaques were modeled. Wall shear stress and velocity pattern were computed from finite element pulsatile blood flow simulations. The results may suggest that wall shear stress changes depend on relative angular position between the aneurysm and the plaque.

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Marcelo A. Castro, Nora L. Peloc, Aichi Chien, Ezequiel Goldberg, Christopher M. Putman, and Juan R. Cebral "Aneurysm flow characteristics in realistic carotid artery aneurysm models induced by proximal virtual stenotic plaques: a computational hemodynamics study", Proc. SPIE 9417, Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging, 941727 (17 March 2015); https://doi.org/10.1117/12.2078555

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KEYWORDS

Arteries

Hemodynamics

3D modeling

Neck

Cerebral aneurysms

Angiography

Blood circulation

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