title: Does Arterial Flow Rate Affect the Assessment of Flow-Diverter Stent Performance?
abstract: Our aim was to assess the performance of flow-diverter stents. The pre- and end-of-treatment angiographies are commonly compared. However, the arterial flow rate may change between acquisitions; therefore, a better understanding of its influence on the local intra-aneurysmal hemodynamics before and after flow-diverter stent use is required.
  
  
  
  Twenty-five image-based aneurysm models extracted from 3D rotational angiograms were conditioned for computational fluid dynamics simulations. Pulsatile simulations were performed at different arterial flow rates, covering a wide possible range of physiologic flows among 1-5 mL/s. The effect of flow-diverter stents on intra-aneurysmal hemodynamics was numerically simulated with a porous medium model. Spatiotemporal-averaged intra-aneurysmal flow velocity and flow rate were calculated for each case to quantify the hemodynamics after treatment. The short-term flow-diverter stent performance was characterized by the relative velocity reduction inside the aneurysm.
  
  
  
  Spatiotemporal-averaged intra-aneurysmal flow velocity before and after flow-diverter stent use is linearly proportional to the mean arterial flow rate (minimum R2> 0.983 of the linear regression models for untreated and stented models). Relative velocity reduction asymptotically decreases with increasing mean arterial flow rate. When the most probable range of arterial flow rate was considered (3-5 mL/s), instead of the wide possible flow range, the mean SD of relative velocity reduction was reduced from 3.6% to 0.48%.
  
  
  
  Both intra-aneurysmal aneurysm velocity and flow-diverter stent performance depend on the arterial flow rate. The performance could be considered independent of the arterial flow rates within the most probable range of physiologic flows.
authors.affiliation: From Medisys-Philips Research (H.G.M., O.Bonnefous), Paris, France hernan.morales@philips.com.
authors.forename: H G
authors.identifier: 0000-0002-2731-2739
authors.initials: HG
authors.lastname: Morales
authors.affiliation: From Medisys-Philips Research (H.G.M., O.Bonnefous), Paris, France.
authors.forename: O
authors.identifier: 0000-0001-6715-8222
authors.initials: O
authors.lastname: Bonnefous
authors.affiliation: Centre for Cardiovascular Science (A.J.G.), University of Edinburgh, Edinburgh, Scotland.|Department of Information and Communication Technologies (A.J.G.), Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: A J
authors.identifier: 0000-0002-7363-1095
authors.initials: AJ
authors.lastname: Geers
authors.affiliation: Department of Information Neuroradiology (O.Brina), University Hospital of Geneva, Geneva, Switzerland.
authors.forename: O
authors.identifier: 0000-0003-1712-0124
authors.initials: O
authors.lastname: Brina
authors.affiliation: Department of Medical Imaging and Department of Surgery (V.M.P.), University Health Network, Toronto, Ontario, Canada.
authors.forename: V M
authors.identifier: 0000-0002-6804-3985
authors.initials: VM
authors.lastname: Pereira
authors.affiliation: Interventional Neuroradiology (L.S., J.M.), Beaujon University Hospital, Clichy, France.|Paris Diderot University (L.S.), Paris, France.
authors.forename: L
authors.identifier: 0000-0002-6748-8528
authors.initials: L
authors.lastname: Spelle
authors.affiliation: Interventional Neuroradiology (L.S., J.M.), Beaujon University Hospital, Clichy, France.
authors.forename: J
authors.identifier: 0000-0002-2086-2973
authors.initials: J
authors.lastname: Moret
authors.affiliation: PLADEMA-CONICET (I.L.), Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.
authors.forename: I
authors.identifier: 0000-0002-7745-1964
authors.initials: I
authors.lastname: Larrabide
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D057446:Hydrodynamics; D002532:Intracranial Aneurysm / Q000628:therapy*; D008955:Models, Cardiovascular; D015607:Stents