Hemodynamics in two tandem aneurysms treated with flow diverters

Area of Science:

• Biomedical Engineering
• Medical Imaging
• Cardiovascular Science

Background:

• Cerebral aneurysms pose significant risks, necessitating effective treatment strategies.
• Flow diverters are increasingly used for treating intracranial aneurysms.
• Understanding factors influencing aneurysm occlusion time post-treatment is crucial for optimizing outcomes.

Purpose of the Study:

• To investigate the relationship between hemodynamic conditions and aneurysm occlusion time after flow diverter treatment.
• To analyze how flow diverters alter blood flow dynamics within cerebral aneurysms.
• To determine if hemodynamic changes predict the rate of aneurysm thrombosis.

Main Methods:

• A case study involving a patient with tandem intracranial aneurysms treated with flow diverters.
• Construction of a patient-specific computational fluid dynamics (CFD) model using 3D rotational angiography.
• Simulation of blood flow under pulsatile conditions to quantify hemodynamic variables before and after device deployment.

Main Results:

• Flow diverters significantly reduced aneurysm inflow, velocity, shear rates, and wall shear stress.
• Post-deployment flow patterns became smoother with less intra-aneurysmal swirling.
• The magnitude of hemodynamic reduction correlated with faster occlusion, particularly in the faster-occluding aneurysm.

Conclusions:

• A larger reduction in hemodynamic factors after flow diverter placement is associated with shorter aneurysm occlusion times.
• These findings suggest that optimizing hemodynamic changes is key to achieving rapid aneurysm thrombosis.
• This insight can refine treatment goals for flow diverter interventions in cerebral aneurysms.