A Multicenter Pilot Study on the Clinical Utility of Computational Modeling for Flow-Diverter Treatment Planning
B W Chong1,2, B R Bendok3, C Krishna3
1From the Department of Neurosurgery (B.W.C., B.R.B., C.K., M.S.), Mayo Clinic, Phoenix, Arizona Chong.Brian@mayo.edu.
AJNR. American Journal of Neuroradiology
|September 28, 2019
Summary
Computational modeling significantly improves flow-diverter sizing for cerebral aneurysm treatment, enhancing physician confidence and leading to different device selections in most cases. Validation confirmed good agreement between simulated and actual device dimensions.
Area of Science:
- Neurosurgery
- Medical Imaging
- Computational Fluid Dynamics
Background:
- Accurate flow-diverter sizing is crucial for successful cerebral aneurysm treatment.
- Current sizing conventions present challenges due to device size, patient anatomy, and deployment complexities.
Purpose of the Study:
- To evaluate if computational modeling enhances flow-diverter sizing compared to conventional methods.
- To validate the accuracy of simulated flow-diverter deployments.
Main Methods:
- Seven neurosurgeons prospectively planned 19 interventions using computational modeling.
- Physicians simulated multiple device sizes and selected a preferred size using conventional methods.
- Post-treatment angiography was compared with simulations for validation.
Main Results:
- Physicians reported increased confidence in device selection in 94.7% of cases.
- 63.2% of cases involved a device size selection different from the initial conventional plan.
- Simulated and clinical flow-diverter lengths showed an average difference of 2.1 mm; diameters agreed within measurement uncertainty in 57% of cases.
Conclusions:
- Computational modeling is a valuable tool for flow-diverter treatment planning.
- Simulations demonstrated good agreement with clinical outcomes in terms of device diameter and length.
Related Concept Videos
01:30Typical Model Studies
620
Fluid mechanics model studies often utilize scaled-down systems to predict fluid behavior in full-scale environments, such as river flows, dam spillways, and structures interacting with open surfaces. Maintaining Froude number similarity in river models is crucial, as it replicates surface flow features like wave patterns and velocities.
620
01:21Design Example: Creating a Hydraulic Model of a Dam Spillway
689
Scaled hydraulic models of dam spillways provide a practical way to replicate and study the intricate flow dynamics of these structures. Often built to a 1:15 ratio, these models allow for observing critical water behavior, such as velocity distribution, flow patterns, and energy dissipation.
689
01:19Urodynamic Studies: Uroflowmetry
3.6K
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
3.6K