Hemodynamic Characterization of Peripheral Arterio-venous Malformations.
Peripheral arterio-venous malformations (pAVMs) are congenital vascular anomalies that require treatment, due to their severe clinical consequences. The complexity of lesions often leads to misdiagnosis and ill-planned treatments. To improve disease management, we developed a computational model to quantify the hemodynamic effects of key angioarchitectural features of pAVMs. Hemodynamic results were used to predict the transport of contrast agent (CA), which allowed us to compare our findings to digital subtraction angiography (DSA) recordings of patients. The model is based on typical pAVM morphologies and a generic vessel network that represents realistic vascular feeding and draining components related to lesions. A lumped-parameter description of the vessel network was employed to compute blood pressure and flow rates. CA-transport was determined by coupling the model to a 1D advection-diffusion equation. Results show that the extent of hemodynamic effects of pAVMs, such as arterial steal and venous hypertension, strongly depends on the lesion type and its vascular architecture. Dimensions of shunting vessels strongly influence hemodynamic parameters. Our results underline the importance of the dynamics of CA-transport in diagnostic DSA images. In this context, we identified a set of temporal CA-transport parameters, which are indicative of the presence and specific morphology of pAVMs.
ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland. sabrina.frey@artorg.unibe.ch.
Sabrina
0000-0002-3981-4437
S
Frey
Division of Angiology, Swiss Cardiovascular Center, University of Bern, Bern University Hospital, Bern, Switzerland.
A
A
Haine
Division of Angiology, Swiss Cardiovascular Center, University of Bern, Bern University Hospital, Bern, Switzerland.
R
R
Kammer
Department of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Bern University Hospital, Bern, Switzerland.
H
H
von Tengg-Kobligk
ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland.
D
D
Obrist
Division of Angiology, Swiss Cardiovascular Center, University of Bern, Bern University Hospital, Bern, Switzerland.
I
I
Baumgartner
D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D006439:Hemodynamics; D006801:Humans; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D054079:Vascular Malformations / Q000000981:diagnostic imaging* / Q000503:physiopathology
D003287:Contrast Media
1D advection–diffusion; Blood flow modelling; Contrast agent transport; Lumped parameter model; Vascular malformations; Yakes AVM classification