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Proceedings Paper

Aneurysm flow characteristics in realistic carotid artery aneurysm models induced by proximal virtual stenotic plaques: a computational hemodynamics study
Author(s): Marcelo A. Castro; Nora L. Peloc; Aichi Chien; Ezequiel Goldberg; Christopher M. Putman; Juan R. Cebral
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Paper Abstract

Cerebral aneurysms may rarely coexist with a proximal artery stenosis. In that small percent of patients, such coexistence poses a challenge for interventional neuroradiologists and neurosurgeons to make the best treatment decision. According to previous studies, the incidence of cerebral aneurysms in patients with internal carotid artery stenosis is no greater than five percent, where the aneurysm is usually incidentally detected, being about two percent for aneurysms and stenoses in the same cerebral circulation. Those cases pose a difficult management decision for the physician. Case reports showed patients who died due to aneurysm rupture months after endarterectomy but before aneurysm clipping, while others did not show any change in the aneurysm after plaque removal, having optimum outcome after aneurysm coiling. The aim of this study is to investigate the intra-aneurysmal hemodynamic changes before and after treatment of stenotic plaque. Virtually created moderate stenoses in vascular models of internal carotid artery aneurysm patients were considered in a number of cases reconstructed from three dimensional rotational angiography images. The strategy to create those plaques was based on parameters analyzed in a previous work where idealized models were considered, including relative distance and stenosis grade. Ipsilateral and contralateral plaques were modeled. Wall shear stress and velocity pattern were computed from finite element pulsatile blood flow simulations. The results may suggest that wall shear stress changes depend on relative angular position between the aneurysm and the plaque.

Paper Details

Date Published: 17 March 2015
PDF: 11 pages
Proc. SPIE 9417, Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging, 941727 (17 March 2015); doi: 10.1117/12.2078555
Show Author Affiliations
Marcelo A. Castro, Univ. Tecnológica Nacional (Argentina)
Texas Neurointerventional Surgery Associates (United States)
Nora L. Peloc, Univ. Favaloro (Argentina)
Aichi Chien, Univ. of California, Los Angeles (United States)
Ezequiel Goldberg, Univ. Tecnológica Nacional (Argentina)
Christopher M. Putman, Texas Neurointerventional Surgery Associates (United States)
Juan R. Cebral, George Mason Univ. (United States)

Published in SPIE Proceedings Vol. 9417:
Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging
Barjor Gimi; Robert C. Molthen, Editor(s)

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