title: Hemodynamic transition driven by stent porosity in sidewall aneurysms.
abstract: The healing process of intracranial aneurysms (IAs) treated with flow diverter stents (FDSs) depends on the IA flow modifications and on the epithelization process over the neck. In sidewall IA models with straight parent artery, two main hemodynamic regimes with different flow patterns and IA flow magnitude were broadly observed for unstented and high porosity stented IA on one side, and low porosity stented IA on the other side. The hemodynamic transition between these two regimes is potentially involved in thrombosis formation. In the present study, CFD simulations and multi-time lag (MTL) particle imaging velocimetry (PIV) measurements were combined to investigate the physical nature of this transition. Measurable velocity fields and non-measurable shear stress and pressure fields were assessed experimentally and numerically in the aneurysm volume in the presence of stents with various porosities. The two main regimes observed in both PIV and CFD showed typical flow features of shear and pressure driven regimes. In particular, the waveform of the averaged IA velocities was matching both the shear stress waveform at IA neck or the pressure gradient waveform in parent artery. Moreover, the transition between the two regimes was controlled by stent porosity: a decrease of stent porosity leads to an increase (decrease) of pressure differential (shear stress) through IA neck. Finally, a good PIV-CFD agreement was found except in transitional regimes and low motion eddies due to small mismatch of PIV-CFD running conditions.
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva, Switzerland; Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Avenue de Cour 33bis, CH-1007 Lausanne, Switzerland. Electronic address: pierre.bouillot@unige.ch.
authors: Pierre
authors: P
authors: Bouillot
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva, Switzerland.
authors: Olivier
authors: O
authors: Brina
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva, Switzerland.
authors: Rafik
authors: R
authors: Ouared
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva, Switzerland.
authors: Karl-Olof
authors: KO
authors: Lovblad
authors: Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Avenue de Cour 33bis, CH-1007 Lausanne, Switzerland.
authors: Mohamed
authors: M
authors: Farhat
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva, Switzerland; Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
authors: Vitor Mendes
authors: VM
authors: Pereira
mesh_terms: D003198:Computer Simulation; D006439:Hemodynamics; D006801:Humans; D057446:Hydrodynamics; D002532:Intracranial Aneurysm / Q000628:therapy*; D016062:Porosity; D011312:Pressure; D012212:Rheology; D033081:Shear Strength; D015607:Stents; D013314:Stress, Mechanical
keywords: Cerebral aneurysm; Computational fluid dynamics; Hemodynamic transition; Hemodynamics; Particle imaging velocimetry; Stent