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Medical & Biological Engineering & Computing

, Volume 51, Issue 8, pp 901–910 | Cite as

Computational fluid dynamics of blood flow in coil-embolized aneurysms: effect of packing density on flow stagnation in an idealized geometry

  • Tomohiro Otani
  • Masanori Nakamura
  • Toshiyuki Fujinaka
  • Masayuki Hirata
  • Junko Kuroda
  • Katsuhiko Shibano
  • Shigeo Wada
Original Article

Abstract

Coil embolization is performed to induce flow stagnation in cerebral aneurysms and enhance blood clot formation, thus preventing rupture and further growth. We investigated hemodynamics in differently positioned aneurysms coiled at various packing densities to determine the effective packing density in terms of flow stagnation. As a first step, hemodynamic simulations were conducted for idealized geometries of both terminal- and sidewall-type aneurysms. Porous media modeling was employed to describe blood flow in coil-embolized aneurysms. The stagnant volume ratio (SVR) was analyzed to quantify the efficacy of coil embolization. Regardless of aneurysm type and angle, SVR increased with increasing packing density, but the increase in SVR varied depending on type. For sidewall-type aneurysms, the packing density required to achieve 60 % SVR was 20 %, roughly independent of aneurysm angle; flow stagnation was achieved at low packing density. In contrast, in terminal-type aneurysms, the packing density required to achieve 60 % SVR was highly dependent on aneurysm angle, accomplishing a 20 % packing density only for lower angles. Indications are that a relatively high packing density would be required, particularly when these aneurysms are angled against the parent artery. The packing density required for flow stagnation varies depending on aneurysm type and relative position.

Keywords

Cerebral aneurysm Computational fluid dynamics Coil embolization Porous media 

Notes

Acknowledgments

This study was supported by Grants-in-Aid for Scientific Research (B) 22300155, Scientific Research (B) 21300163 and Challenging Exploratory Research 23650261 from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT). We wish to acknowledge Dr. Satoshi Ii for discussions on the analysis of flow.

References

  1. 1.
    Bird RB, Stewart WE, Lightfoot EN (2002) Interphase transport in isothermal systems. In: Kulek P (ed) Transport Phenomena, 2nd edn. John Wiley & Sons, New York, pp 177–196Google Scholar
  2. 2.
    Brinjikji W, Rabinstein AA, Nasr DM, Lanzino G, Kallmes DF, Cloft HJ (2011) Better outcomes with treatment by coiling relative to clipping of unruptured intracranial aneurysms in the United States, 2001–2008. AJNR Am J Neuroradiol 32:1071–1075CrossRefPubMedGoogle Scholar
  3. 3.
    Byun HS, Rhee K (2004) CFD modeling of blood flow following coil embolization of aneurysms. Med Eng Phys 26:755–761CrossRefPubMedGoogle Scholar
  4. 4.
    Cha KS, Balaras E, Lieber BB, Sadasivan C, Wakhloo AK (2007) Modeling the interaction of coils with the local blood flow after coil embolization of intracranial aneurysms. J Biomech Eng 129:873–879CrossRefPubMedGoogle Scholar
  5. 5.
    Cebral JR, Castro MA, Burgess JE, Pergolizzi RS, Sheridan MJ, Putman CM (2005) Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models. AJNR Am J Neuroradiol 26:2550–2559PubMedGoogle Scholar
  6. 6.
    Dequidt J, Marchal M, Duriez C, Kerien E, Cotin S (2008) Interactive simulation of embolization coils: modeling and experimental validation. Med Image Comput Comput Assist Interv 11:695–702PubMedGoogle Scholar
  7. 7.
    Dequidt J, Duriez C, Cotin S, Kerrien E (2009) Towards interactive planning of coil embolization in brain aneurysms. Med Image Comput Comput Assist Interv 12:377–385PubMedGoogle Scholar
  8. 8.
    Ergun S (1952) Fluid flow through packed columns. Chem Eng Prog 48:89–94Google Scholar
  9. 9.
    Ferns SP, Sprengers ME, van Rooij WJ, Rinkel GJ, van Rijn JC, Bipat S, Sluzewski M, Majoie CB (2009) Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke 40:e523–e529CrossRefPubMedGoogle Scholar
  10. 10.
    Ford MD, Lee SW, Lownie SP, Holdsworth DW, Steinman DA (2008) On the effect of parent-aneurysm angle on flow patterns in basilar tip aneurysms: towards a surrogate geometric marker of intra-aneurismal hemodynamics. J Biomech 41:241–248CrossRefPubMedGoogle Scholar
  11. 11.
    Gobin YP, Counord JL, Flaud P, Duffaux J (1994) In vitro study of haemodynamics in a giant saccular aneurysm model: influence of flow dynamics in the parent vessel and effects of coil embolization. Neuroradiology 36:530–536CrossRefPubMedGoogle Scholar
  12. 12.
    Groden C, Laudan J, Gatchell S, Zeumer H (2001) Three-dimensional pulsatile flow simulation before and after endovascular coil embolization of a terminal cerebral aneurysm. J Cereb Blood Flow Metab 21:1464–1471CrossRefPubMedGoogle Scholar
  13. 13.
    Imai Y, Sato K, Ishikawa T, Yamaguchi T (2008) Inflow into saccular cerebral aneurysms at arterial bends. Ann Biomed Eng 36:1489–1495CrossRefPubMedGoogle Scholar
  14. 14.
    Ishikawa T, Guimaraes LFR, Oshima S, Yamane R (1998) Effect of non-Newtonian property of blood on flow through stenosed tube. Fluid Dyn Res 22:251–264CrossRefGoogle Scholar
  15. 15.
    Kakalis NM, Mitsos AP, Byrne JV, Ventikos Y (2008) The haemodynamics of endovascular aneurysm treatment: a computational modelling approach for estimating the influence of multiple coil deployment. IEEE Trans Med Imaging 27:814–824CrossRefPubMedGoogle Scholar
  16. 16.
    Kawanabe Y, Sadato A, Taki W, Hashimoto N (2001) Endovascular occlusion of intracranial aneurysms with Guglielmi detachable coils: correlation between coil packing density and coil compaction. Acta Neurochir (Wien) 143:451–455CrossRefGoogle Scholar
  17. 17.
    Khanafer K, Berguer R, Schlicht M, Bull J (2009) Numerical modeling of coil compaction in the treatment of cerebral aneurysms using porous media theory. Journal of Porous Media 12:887–897CrossRefGoogle Scholar
  18. 18.
    López JA, Chen J (2009) Pathophysiology of venous thrombosis. Thromb Res 123:S30–S34CrossRefPubMedGoogle Scholar
  19. 19.
    Mitsos AP, Kakalis NM, Ventikos YP, Byrne JV (2008) Haemodynamic simulation of aneurysm coiling in an anatomically accurate computational fluid dynamics model: technical note. Neuroradiology 50:341–347CrossRefPubMedGoogle Scholar
  20. 20.
    Molyneux A, Kerr R, International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R (2002) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized trial. J Stroke Cerebrovasc Dis 11:304–314CrossRefPubMedGoogle Scholar
  21. 21.
    Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P, International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group (2005) International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809–817CrossRefPubMedGoogle Scholar
  22. 22.
    Morales HG, Kim M, Vivas EE, Villa-Uriol MC, Larrabide I, Sola T, Guimaraens L, Frangi AF (2011) How do coil configuration and packing density influence intra-aneurysmal hemodynamics? AJNR Am J Neuroradiol 32:1935–1941CrossRefPubMedGoogle Scholar
  23. 23.
    Morales H, Larrabide I, Geers A, San Roman L, Blasco J, Macho J, Frangi A (2012) A virtual coiling technique for image-based aneurysm models by dynamic path planning. IEEE Trans Med Imaging 32:119–129Google Scholar
  24. 24.
    Parlea L, Fahrig R, Holdsworth DW, Lownie SP (1999) An analysis of the geometry of saccular intracranial aneurysms. AJNR Am J Neuroradiol 20:1079–1089PubMedGoogle Scholar
  25. 25.
    Raymond J, Darsaut T, Salazkin I, Gevry G, Bouzeghrane F (2008) Mechanisms of Occlusion and Recanalization in Canine Carotid Bifurcation Aneurysms Embolized with Platinum Coils: an Alternative Concept. AJNR Am J Neuroradiol 29:745–752CrossRefPubMedGoogle Scholar
  26. 26.
    Sato K, Imai Y, Ishikawa T, Matsuki N, Yamaguchi T (2008) The importance of parent artery geometry in intra-aneurysmal hemodynamics. Med Eng Phys 30:774–782CrossRefPubMedGoogle Scholar
  27. 27.
    Schirmer CM, Malek AM (2010) Critical influence of framing coil orientation on intra-aneurysmal and neck-region hemodynamics in a sidewall aneurysm model. Neurosurgery 67:1692–1702CrossRefPubMedGoogle Scholar
  28. 28.
    Slob MJ, van Rooij WJ, Sluzewski M (2005) Coil thickness and packing of cerebral aneurysms: a comparative study of two types of coils. AJNR Am J Neuroradiol 26:901–903PubMedGoogle Scholar
  29. 29.
    Sluzewski M, van Rooij WJ, Slob MJ, Bescós JO, Slump CH, Wijnalda D (2004) Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils. Radiology 231:653–658CrossRefPubMedGoogle Scholar
  30. 30.
    STAR-CCM + User guide, Ver. 4.02.007 CD-Adapco, pp 828–883Google Scholar
  31. 31.
    Steinman DA, Milner JS, Norley CJ, Lownie SP, Holdsworth DW (2003) Image-based computational simulation of flow dynamics in a giant intracranial aneurysm. AJNR Am J Neuroradiol 24:559–566PubMedGoogle Scholar
  32. 32.
    Tamatani S, Ito Y, Abe H, Koike T, Takeuchi S, Tanaka R (2002) Evaluation of the stability of aneurysms after embolization using detachable coils: correlation between stability of aneurysms and embolized volume of aneurysms. AJNR Am J Neuroradiol 23:762–767PubMedGoogle Scholar
  33. 33.
    Yagi K, Satoh K, Satomi J, Matsubara S, Nagahiro S (2005) Evaluation of aneurysm stability after endovascular embolization with guglielmi detachable coils: correlation between long-term stability and volume embolization ratio. Neurol Med Chir (Tokyo) 45:561–566CrossRefGoogle Scholar

Copyright information

© International Federation for Medical and Biological Engineering 2013

Authors and Affiliations

  • Tomohiro Otani
    • 1
  • Masanori Nakamura
    • 2
  • Toshiyuki Fujinaka
    • 3
  • Masayuki Hirata
    • 3
  • Junko Kuroda
    • 3
  • Katsuhiko Shibano
    • 3
  • Shigeo Wada
    • 1
  1. 1.Graduate School of Engineering ScienceOsaka UniversityToyonakaJapan
  2. 2.Graduate School of Science and EngineeringSaitama UniversitySaitama-shiJapan
  3. 3.Department of Neurosurgery, Graduate School of MedicineOsaka UniversitySuitaJapan

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