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Nair P, Chong BW, Indahlastari A, Lindsay J, DeJeu D, Parthasarathy V, Ryan J, Babiker H, Workman C, Gonzalez LF, Frakes D. Hemodynamic characterization of geometric cerebral aneurysm templates. J Biomech 2015; 49:2118-2126. [PMID: 26654674 DOI: 10.1016/j.jbiomech.2015.11.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 11/13/2015] [Indexed: 10/22/2022]
Abstract
Hemodynamics are currently considered to a lesser degree than geometry in clinical practices for evaluating cerebral aneurysm (CA) risk and planning CA treatment. This study establishes fundamental relationships between three clinically recognized CA geometric factors and four clinically relevant hemodynamic responses. The goal of the study is to develop a more combined geometric/hemodynamic basis for informing clinical decisions. Flows within eight idealized template geometries were simulated using computational fluid dynamics and measured using particle image velocimetry under both steady and pulsatile flow conditions. The geometric factor main effects were then analyzed to quantify contributions made by the geometric factors (aneurysmal dome size (DS), dome-to-neck ratio (DNR), and parent-vessel contact angle (PV-CA)) to effects on the hemodynamic responses (aneurysmal and neck-plane root-mean-square velocity magnitude (Vrms), aneurysmal wall shear stress (WSS), and cross-neck flow (CNF)). Two anatomical aneurysm models were also examined to investigate how well the idealized findings would translate to more realistic CA geometries. DNR made the greatest contributions to effects on hemodynamics including a 75.05% contribution to aneurysmal Vrms and greater than 35% contributions to all responses. DS made the next greatest contributions, including a 43.94% contribution to CNF and greater than 20% contributions to all responses. PV-CA and several factor interactions also made contributions of greater than 10%. The anatomical aneurysm models and the most similar idealized templates demonstrated consistent hemodynamic response patterns. This study demonstrates how individual geometric factors, and combinations thereof, influence CA hemodynamics. Bridging the gap between geometry and flow in this quantitative yet practical way may have potential to improve CA evaluation and treatment criteria. Agreement among results from idealized and anatomical models further supports the potential for a template-based approach to play a useful role in clinical practice.
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Affiliation(s)
- Priya Nair
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States.
| | - Brian W Chong
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States; Mayo Clinic Hospital, Phoenix, AZ, United States
| | - Aprinda Indahlastari
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - James Lindsay
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - David DeJeu
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Varsha Parthasarathy
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Justin Ryan
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | | | - Christopher Workman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - L Fernando Gonzalez
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, United States
| | - David Frakes
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States; School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe, AZ, United States
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