Understanding the effect of effective metal surface area of flow diverter stent's on the patient-specific intracranial aneurysm numerical model using Lagrangian coherent structures

J Clin Neurosci. 2020 Oct:80:298-309. doi: 10.1016/j.jocn.2020.04.111. Epub 2020 Jul 22.

Abstract

The effective metal surface area (EMSA) of flow diversions plays an essential role in the occlusion mechanism inside the aneurysm since the value of EMSA determines the amount of blood flow into the aneurysm sac. In the present study, three different models of a flow diverter stent, namely FRED 4017, FRED 4038, and FRED 4539, were virtually placed at the aneurysm neck of a 52-years-old female patient to identify the effect of EMSA on stagnation region formation inside the aneurysm sac. Lagrangian coherent structures (LCSs), hyperbolic time, and particle tracking analysis were employed to the velocity vectors obtained from computational fluid dynamics (CFD). It is noticed that use of FRED 4017 stent with 0.42 EMSA value caused nearly 40% of the weightless blood flow particles (more than FRED 4038 and FRED 4539) to stay inside the aneurysm while only 0.35% of the blood flow was remaining inside the aneurysm sac when no stent was placed into the aneurysm site. Furthermore, hyperbolic time computations illustrated the formation of stagnation fluid flow zones that can be associated with the residence time of the blood flow particles. Lastly, the results of hyperbolic time analysis are in good agreement with digital subtraction angiography (DSA) images taken in the clinic a few minutes after a FRED 4017 implantation.

Keywords: Computational fluid dynamics (CFD); Effective metal surface area (EMSA); Flow diversion; Hyperbolic time; Lagrangian coherent structures (LCSs); Particle tracking.

Publication types

  • Case Reports

MeSH terms

  • Angiography, Digital Subtraction / methods*
  • Cerebrovascular Circulation / physiology*
  • Female
  • Hemodynamics / physiology
  • Humans
  • Hydrodynamics*
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / physiopathology*
  • Intracranial Aneurysm / surgery*
  • Middle Aged
  • Self Expandable Metallic Stents* / trends