Hemodynamic models of cerebral aneurysms for assessment of effect of vessel geometry on risk of rupture

Predicting the risk of rupture for vertebral aneurysm based on geometric features of blood vessels

A significant proportion of the adult population worldwide suffers from cerebral aneurysms. If left untreated, aneurysms may rupture and lead to fatal massive internal bleeding. On the other hand, treatment of aneurysms also involve significant risks. It is desirable, therefore, to have an objective tool that can be used to predict the risk of rupture and assist in surgical decision for operating on the aneurysms. Currently, such decisions are made mostly based on medical expertise of the healthcare team. In this paper, we investigate the possibility of using machine learning algorithms to predict rupture risk of vertebral artery fusiform aneurysms based on geometric features of the blood vessels surrounding but excluding the aneurysm. For each of the aneurysm images (12 ruptured and 25 unruptured), the vessel is segmented into distal and proximal parts by cross-sectional area and 382 non-aneurysm-related geometric features extracted. The decision tree model using two of the features (standard deviation of eccentricity of proximal vessel, and diameter at the distal endpoint) achieved 83.8% classification accuracy. Additionally, with support vector machine and logistic regression, we also achieved 83.8% accuracy with another set of two features (ratio of mean curvature between distal and proximal parts, and diameter at the distal endpoint). Combining the aforementioned three features with integration of curvature of proximal vessel and also ratio of mean cross-sectional area between distal and proximal parts, these models achieve an impressive 94.6% accuracy. These results strongly suggest the usefulness of geometric features in predicting the risk of rupture.

The Numerical Study of the Hemodynamic Characteristics in the Patient-Specific Intracranial Aneurysms before and after Surgery

The patient-specific pre- and postsurgery cerebral arterial geometries in the study were reconstructed from computed tomography angiography (CTA). Three-dimensional computational fluid dynamics models were used to investigate the hemodynamic phenomena in the cerebral arteries before and after surgery of the aneurysm under realistic conditions. CFD simulations for laminar flow of incompressible Newtonian fluid were conducted by using commercial software, ANSYS v15, with the rigid vascular wall assumption. The study found that the flow patterns with the complex vortical structures inside the aneurysm were similar. We also found that the inflow jet streams were coming strongly in aneurysm sac in the presurgery models, while the flow patterns in postsurgery models were quite different from those in presurgery models. The average wall shear stress after surgery for model 1 was approximately three times greater than that before surgery, while it was about twenty times greater for model 2. The area of low WSS in the daughter saccular aneurysm region in model 2 is associated with aneurysm rupture. Thus the distribution of WSS in aneurysm region provides useful prediction for the risk of aneurysm rupture.

A geometric scaling model for assessing the impact of aneurysm size ratio on hemodynamic characteristics

Background

The intracranial aneurysm (IA) size has been proved to have impacts on the hemodynamics and can be applied for the prediction of IA rupture risk. Although the relationship between aspect ratio and hemodynamic parameters was investigated using real patients and virtual models, few studies focused on longitudinal experiments of IAs based on patient-specific aneurysm models. We attempted to do longitudinal simulation experiments of IAs by developing a series of scaled models.

Methods

In this work, a novel scaling approach was proposed to create IA models with different aneurysm size ratios (ASRs) defined as IA height divided by average neck diameter from a patient-specific aneurysm model and the relationship between the ASR and hemodynamics was explored based on a simulated longitudinal experiment. Wall shear stress, flow patterns and vessel wall displacement were computed from these models. Pearson correlation analysis was performed to elucidate the relationship between the ASR and wall shear stress. The correlation of the ASR and flow velocity was also computed and analyzed.

Results

The experiment results showed that there was a significant increase in IA area exposed to low WSS once the ASR > 0.7, and the flow became slower and the blood was more difficult to flow into the aneurysm as the ASR increased. Meanwhile, the results also indicated that average blood flow velocity and WSS had strongly negative correlations with the ASR (r = −0.938 and −0.925, respectively). A narrower impingement region and a more concentrated inflow jet appeared as the ASR increased, and the large local deformation at aneurysm apex could be found as the ASR >1.7 or 0.7 < the ASR <1.0.

Conclusion

Hemodynamic characteristics varied with the ASR. Besides, it is helpful to further explore the relationship between morphologies and hemodynamics based on a longitudinal simulation by building a series of patient-specific aneurysm scaled models applying our proposed IA scaling algorithm.

Hemodynamics and anatomy of elastase-induced rabbit aneurysm models: similarity to human cerebral aneurysms?

BACKGROUND AND PURPOSE

Animal models provide a mechanism for fundamental studies of the coupling between hemodynamics and pathophysiology in diseases such as saccular aneurysms. In this work, we evaluated the capability of an elastase-induced saccular aneurysm model in rabbits to reproduce the anatomic and hemodynamic features typical for human intracranial aneurysms.

MATERIALS AND METHODS

Saccular aneurysms were created in 51 rabbits at the origin of the RCCA. Twelve weeks' postcreation, the lumen geometry of the aneurysm and surrounding vasculature was acquired by using 3DRA. Geometric features of these models were measured. Pulsatile 3D CFD studies were performed with rabbit-specific inlet profiles.

RESULTS

Geometric features, including aneurysm height, width, neck diameter, aspect ratio, and NSI of all 51 rabbit aneurysm models fell within the range reported for human IAs. The distribution and range in values of pressure, WSS, and OSI were also typical for human IAs. A single recirculation region was observed in 33 (65%) of 51 cases, whereas a second transient recirculation zone was observed in 18 (35%) cases. Both of these flow types are commonly observed in human IAs.

CONCLUSIONS

Most hemodynamic and geometric features in a commonly used elastase-induced rabbit saccular aneurysm model are qualitatively and quantitatively similar to those seen in large numbers of human cerebral aneurysms.