Department of Neuroradiology, University Hospitals of Geneva, Switzerland; Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Avenue de Cour 33bis, Lausanne CH-1007, Switzerland.
Department of Neuroradiology, University Hospitals of Geneva, Switzerland.
Med Image Anal. 2016 May;30:85-94. doi: 10.1016/j.media.2016.01.006. Epub 2016 Jan 30.
The prediction of flow diverter stent (FDS) implantation for the treatment of intracranial aneurysms (IAs) is being increasingly required for hemodynamic simulations and procedural planning. In this paper, a deployment model was developed based on geometrical properties of braided stents. The proposed mathematical description is first applied on idealized toroidal vessels demonstrating the stent shortening in curved vessels. It is subsequently generalized to patient specific vasculature predicting the position of the filaments along with the length and local porosity of the stent. In parallel, in-vitro and in-vivo FDS deployments were measured by contrast-enhanced cone beam CT (CBCT) in idealized and patient-specific geometries. These measurements showed a very good qualitative and quantitative agreement with the virtual deployments and provided experimental validations of the underlying geometrical assumptions. In particular, they highlighted the importance of the stent radius assessment in the accuracy of the deployment prediction. Thanks to its low computational cost, the proposed model is potentially implementable in clinical practice providing critical information for patient safety and treatment outcome assessment.
血流导向装置（FDS）植入术治疗颅内动脉瘤（IAs）的预测越来越需要血流动力学模拟和手术规划。本文基于编织支架的几何特性开发了一种展开模型。该数学描述首先应用于理想的环形血管，以证明支架在弯曲血管中的缩短。随后，它被推广到特定于患者的脉管系统，预测沿着支架的长度和局部孔隙率的丝的位置。同时，通过对比增强锥形束 CT（CBCT）在理想和患者特定的几何形状中测量体外和体内 FDS 的展开情况。这些测量结果与虚拟展开非常吻合，定性和定量都很好，并且为基础的几何假设提供了实验验证。特别是，它们强调了评估支架半径对展开预测准确性的重要性。由于其计算成本低，因此所提出的模型具有在临床实践中的潜在可实施性，为患者安全性和治疗结果评估提供了关键信息。
