title: A numerical framework to investigate hemodynamics during endovascular mechanical recanalization in acute stroke.
abstract: Ischemic stroke, caused by embolism of cerebral vessels, inflicts high morbidity and mortality. Endovascular aspiration of the blood clot is an interventional technique for the recanalization of the occluded arteries. However, the hemodynamics in the Circle of Willis (CoW) are not completely understood, which results in medical misjudgment and complications during surgeries. In this study we establish a multiscale description of cerebral hemodynamics during aspiration thrombectomy. First, the CoW is modeled as a 1D pipe network on the basis of computed tomography angiography (CTA) scans. Afterwards, a vascular occlusion is placed in the middle cerebral artery and the relevant section of the CoW is transferred to a 3D computational fluid dynamic (CFD) domain. A suction catheter in different positions is included in the CFD simulations. The boundary conditions of the 3D domain are taken from the 1D domain to ensure system coupling. A Eulerian-Eulerian multiphase simulation describes the process of thrombus aspiration. The physiological blood flow in the 1D and 3D domains is validated with literature data. Further on, it is proved that domain reduction and pressure coupling at the boundaries are an appropriate method to reduce computational costs. Future work will apply the developed framework to various clinical questions.
authors.affiliation: Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Neidlin
authors.affiliation: Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Büsen
authors.affiliation: Clinic for Diagnostic and Interventional Neuroradiology, RWTH Aachen University Clinic, Aachen, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Brockmann
authors.affiliation: Clinic for Diagnostic and Interventional Neuroradiology, RWTH Aachen University Clinic, Aachen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Wiesmann
authors.affiliation: Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Sonntag
authors.affiliation: Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinseifer
authors.affiliation: Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
authors.forename: Tim A S
authors.initials: TA
authors.lastname: Kaufmann
mesh_terms: D057510:Endovascular Procedures; D006439:Hemodynamics; D006801:Humans; D008955:Models, Cardiovascular; D009716:Numerical Analysis, Computer-Assisted; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology* / Q000601:surgery*; D013396:Suction; D013927:Thrombosis / Q000473:pathology; D014655:Vascular Resistance
keywords: aspiration; cerebral hemodynamics; multiscale simulation; stroke intervention; thrombectomy