Mines Paris, Université PSL, CEMEF, UMR7635 CNRS, Sophia Antipolis, 06904, France.
Department of Neuro-Interventional and Vascular Interventional, University Hospital of Nice, Nice, 06000, France.
Comput Biol Med. 2024 Sep;180:109023. doi: 10.1016/j.compbiomed.2024.109023. Epub 2024 Aug 19.
Flow-diverter stents offer clinicians an effective solution for treating intracranial aneurysms, especially in cases where other devices may be unsuitable. However, strongly deviating success rates among different centres, manufacturers, and aneurysm phenotypes highlight the need for better in-situ studies of these devices. To support research in this area, virtual stenting algorithms have been proposed that, combined with computational fluid dynamics, provide insights into the hemodynamic alterations induced by the device. Yet, many existing algorithms rely on uncertain parameters, such as the forces applied during operation, fail to predict the length of the device after deployment, or lack robust validation steps, raising concerns about their reliability. Therefore, we developed a robust deployment technique that builds upon the geometrical features of the vessel and includes advancements from previous works. The algorithm is detailed and validated against literature examples, in-vitro experiments, and patient data, achieving a mean angular error below 5° in the latter. Furthermore, we describe and demonstrate how the deployed device can be embedded in a computational mesh using open-source tools and anisotropic meshing routines.
血流导向装置为临床医生提供了一种治疗颅内动脉瘤的有效方法,特别是在其他器械可能不适用的情况下。然而,不同中心、制造商和动脉瘤表型之间成功率存在显著差异,这凸显了需要对这些器械进行更好的原位研究。为了支持该领域的研究,已经提出了虚拟支架置入算法,该算法与计算流体动力学相结合,可以深入了解器械引起的血液动力学改变。然而,许多现有的算法依赖于不确定的参数,例如在操作过程中施加的力,无法预测器械放置后的长度,或者缺乏稳健的验证步骤,这引发了对其可靠性的担忧。因此,我们开发了一种稳健的放置技术,该技术基于血管的几何特征,并包含了之前工作的改进。该算法详细描述并针对文献中的例子、体外实验和患者数据进行了验证,在后者中实现了平均角度误差低于 5°。此外,我们还描述并展示了如何使用开源工具和各向异性网格划分例程将放置的器械嵌入计算网格中。