13 Citations (Scopus)

Abstract

Background: Giant intracranial aneurysms are rare lesions that present uniquely complex therapeutic challenges. Computational fluid dynamics (CFD) has been used to simulate the hemodynamic environments of developing and ruptured cerebral aneurysms. In this study, we use CFD to examine retrospectively hemodynamic changes during the complicated clinical course of a giant carotid aneurysm. Objective: To take an innovative, CFD-based approach to retrospective analysis of the surgical management and clinical course of a giant carotid aneurysm. Methods: Pre- and posttreatment image data were first segmented to produce computational aneurysm models. Flow within the models was then simulated using CFD. Simulated flow and wall shear stress (WSS) profiles were analyzed and used to examine hemodynamic changes during the clinical course of the patient, after 2 independent treatments. Results: Greater WSS magnitudes and a more localized flow impingement region were observed at the distal portion of the aneurysm after both clinical interventions. These relative, acute changes in hemodynamic features at the distal aneurysm wall were greatest after the second intervention and may have preceded rupture of the aneurysm in that region. Conclusions: The application of CFD to the management of a giant intracranial aneurysm showed unexpected posttreatment changes in flow and WSS profiles. The simulation results offer a viable explanation for the observed clinical course. This study demonstrates potential for the use of CFD preoperatively for decision-making in the surgical and endovascular management of intracranial aneurysms.

Original languageEnglish (US)
Pages (from-to)1057-1065
Number of pages9
JournalWorld Neurosurgery
Volume83
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Internal Carotid Artery
Hydrodynamics
Aneurysm
Intracranial Aneurysm
Hemodynamics
Ruptured Aneurysm
Rupture
Decision Making
Therapeutics

Keywords

  • Cerebrovascular
  • Computational fluid dynamics
  • Extracranial/intracranial bypass
  • Flow modeling
  • Giant cerebral aneurysm
  • Wall shear stress

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Computational Fluid Dynamics to Evaluate the Management of a Giant Internal Carotid Artery Aneurysm. / Russin, Jonathan; Babiker, Haithem; Ryan, Justin; Rangel-Castilla, Leonardo; Frakes, David; Nakaji, Peter.

In: World Neurosurgery, Vol. 83, No. 6, 01.06.2015, p. 1057-1065.

Research output: Contribution to journalArticle

Russin, Jonathan ; Babiker, Haithem ; Ryan, Justin ; Rangel-Castilla, Leonardo ; Frakes, David ; Nakaji, Peter. / Computational Fluid Dynamics to Evaluate the Management of a Giant Internal Carotid Artery Aneurysm. In: World Neurosurgery. 2015 ; Vol. 83, No. 6. pp. 1057-1065.
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abstract = "Background: Giant intracranial aneurysms are rare lesions that present uniquely complex therapeutic challenges. Computational fluid dynamics (CFD) has been used to simulate the hemodynamic environments of developing and ruptured cerebral aneurysms. In this study, we use CFD to examine retrospectively hemodynamic changes during the complicated clinical course of a giant carotid aneurysm. Objective: To take an innovative, CFD-based approach to retrospective analysis of the surgical management and clinical course of a giant carotid aneurysm. Methods: Pre- and posttreatment image data were first segmented to produce computational aneurysm models. Flow within the models was then simulated using CFD. Simulated flow and wall shear stress (WSS) profiles were analyzed and used to examine hemodynamic changes during the clinical course of the patient, after 2 independent treatments. Results: Greater WSS magnitudes and a more localized flow impingement region were observed at the distal portion of the aneurysm after both clinical interventions. These relative, acute changes in hemodynamic features at the distal aneurysm wall were greatest after the second intervention and may have preceded rupture of the aneurysm in that region. Conclusions: The application of CFD to the management of a giant intracranial aneurysm showed unexpected posttreatment changes in flow and WSS profiles. The simulation results offer a viable explanation for the observed clinical course. This study demonstrates potential for the use of CFD preoperatively for decision-making in the surgical and endovascular management of intracranial aneurysms.",
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AU - Nakaji, Peter

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N2 - Background: Giant intracranial aneurysms are rare lesions that present uniquely complex therapeutic challenges. Computational fluid dynamics (CFD) has been used to simulate the hemodynamic environments of developing and ruptured cerebral aneurysms. In this study, we use CFD to examine retrospectively hemodynamic changes during the complicated clinical course of a giant carotid aneurysm. Objective: To take an innovative, CFD-based approach to retrospective analysis of the surgical management and clinical course of a giant carotid aneurysm. Methods: Pre- and posttreatment image data were first segmented to produce computational aneurysm models. Flow within the models was then simulated using CFD. Simulated flow and wall shear stress (WSS) profiles were analyzed and used to examine hemodynamic changes during the clinical course of the patient, after 2 independent treatments. Results: Greater WSS magnitudes and a more localized flow impingement region were observed at the distal portion of the aneurysm after both clinical interventions. These relative, acute changes in hemodynamic features at the distal aneurysm wall were greatest after the second intervention and may have preceded rupture of the aneurysm in that region. Conclusions: The application of CFD to the management of a giant intracranial aneurysm showed unexpected posttreatment changes in flow and WSS profiles. The simulation results offer a viable explanation for the observed clinical course. This study demonstrates potential for the use of CFD preoperatively for decision-making in the surgical and endovascular management of intracranial aneurysms.

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