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<meta name="DC.Title" content="Analysis of Hemodynamics and Aneurysm Occlusion after Flow-Diverting Treatment in Rabbit Models" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3913" />
<meta name="DC.Date" content="2014-08-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Predicting the outcome of flow diversion treatment of cerebral aneurysms remains challenging. Our aim was to investigate the relationship between hemodynamic conditions created immediately after flow diversion and subsequent occlusion of experimental aneurysms in rabbits.

MATERIALS AND METHODS: The hemodynamic environment before and after flow-diversion treatment of elastase-induced aneurysms in 20 rabbits was modeled by using image-based computational fluid dynamics. Local aneurysm occlusion was quantified by using a voxelization technique on 3D images acquired 8 weeks after treatment. Global and local voxel-by-voxel hemodynamic variables were used to statistically compare aneurysm regions that later thrombosed to regions that remained patent.

RESULTS: Six aneurysms remained patent at 8 weeks, while 14 were completely or nearly completely occluded. Patent aneurysms had statistically larger neck sizes ( P = .0015) and smaller mean transit times ( P = .02). The velocity, vorticity, and shear rate were approximately 2.8 times ( P &lt; .0001) larger in patent regions—that is, they had larger “flow activity” than regions that progressed to occlusion. Statistical models based on local hemodynamic variables were capable of predicting local occlusion with good precision (84% accuracy), especially away from the neck (92%–94%). Predictions near the neck were poorer (73% accuracy).

CONCLUSIONS: These results suggests that the dominant healing mechanism of occlusion within the aneurysm dome is related to slow-flow-induced thrombosis, while near the neck, other processes could be at play simultaneously.

CFD
:   computational fluid dynamics
FD
:   flow-diverting
3DRA
:   3D rotational angiography" />
<meta name="DC.Contributor" content="J.R. Cebral" />
<meta name="DC.Contributor" content="F. Mut" />
<meta name="DC.Contributor" content="M. Raschi" />
<meta name="DC.Contributor" content="S. Hodis" />
<meta name="DC.Contributor" content="Y.-H. Ding" />
<meta name="DC.Contributor" content="B.J. Erickson" />
<meta name="DC.Contributor" content="R. Kadirvel" />
<meta name="DC.Contributor" content="D.F. Kallmes" />
<meta name="article:published_time" content="2014-08-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Analysis of Hemodynamics and Aneurysm Occlusion after Flow-Diverting Treatment in Rabbit Models" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Predicting the outcome of flow diversion treatment of cerebral aneurysms remains challenging. Our aim was to investigate the relationship between hemodynamic conditions created immediately after flow diversion and subsequent occlusion of experimental aneurysms in rabbits.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The hemodynamic environment before and after flow-diversion treatment of elastase-induced aneurysms in 20 rabbits was modeled by using image-based computational fluid dynamics. Local aneurysm occlusion was quantified by using a voxelization technique on 3D images acquired 8 weeks after treatment. Global and local voxel-by-voxel hemodynamic variables were used to statistically compare aneurysm regions that later thrombosed to regions that remained patent.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Six aneurysms remained patent at 8 weeks, while 14 were completely or nearly completely occluded. Patent aneurysms had statistically larger neck sizes (&lt;i&gt;P&lt;/i&gt; = .0015) and smaller mean transit times (&lt;i&gt;P&lt;/i&gt; = .02). The velocity, vorticity, and shear rate were approximately 2.8 times (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001) larger in patent regions—that is, they had larger “flow activity” than regions that progressed to occlusion. Statistical models based on local hemodynamic variables were capable of predicting local occlusion with good precision (84% accuracy), especially away from the neck (92%–94%). Predictions near the neck were poorer (73% accuracy).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;These results suggests that the dominant healing mechanism of occlusion within the aneurysm dome is related to slow-flow-induced thrombosis, while near the neck, other processes could be at play simultaneously.&lt;/p&gt;" />
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<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=Q. Huang;citation_author=J. Xu;citation_author=J. Cheng;citation_title=Hemodynamic changes by flow diverters in rabbit aneurysm models: a computational fluid dynamic study based on micro-computed tomography reconstruction;citation_volume=44;citation_year=2013;citation_pmid=23640830;citation_doi=10.1161/STROKEAHA.113.001202" />
<meta name="citation_reference" content="citation_title=Flow diversion in rabbit aneurysm models;citation_author=JR. Cebral;citation_author=F. Mut;citation_author=M. Raschi" />
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<meta name="twitter:title" content="Analysis of Hemodynamics and Aneurysm Occlusion after Flow-Diverting Treatment in Rabbit Models" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Predicting the outcome of flow diversion treatment of cerebral aneurysms remains challenging. Our aim was to investigate the relationship between hemodynamic conditions created immediately after flow diversion and subsequent occlusion of experimental aneurysms in rabbits.

MATERIALS AND METHODS: The hemodynamic environment before and after flow-diversion treatment of elastase-induced aneurysms in 20 rabbits was modeled by using image-based computational fluid dynamics. Local aneurysm occlusion was quantified by using a voxelization technique on 3D images acquired 8 weeks after treatment. Global and local voxel-by-voxel hemodynamic variables were used to statistically compare aneurysm regions that later thrombosed to regions that remained patent.

RESULTS: Six aneurysms remained patent at 8 weeks, while 14 were completely or nearly completely occluded. Patent aneurysms had statistically larger neck sizes ( P = .0015) and smaller mean transit times ( P = .02). The velocity, vorticity, and shear rate were approximately 2.8 times ( P &lt; .0001) larger in patent regions—that is, they had larger “flow activity” than regions that progressed to occlusion. Statistical models based on local hemodynamic variables were capable of predicting local occlusion with good precision (84% accuracy), especially away from the neck (92%–94%). Predictions near the neck were poorer (73% accuracy).

CONCLUSIONS: These results suggests that the dominant healing mechanism of occlusion within the aneurysm dome is related to slow-flow-induced thrombosis, while near the neck, other processes could be at play simultaneously.

CFD
:   computational fluid dynamics
FD
:   flow-diverting
3DRA
:   3D rotational angiography" />
<meta name="og-title" property="og:title" content="Analysis of Hemodynamics and Aneurysm Occlusion after Flow-Diverting Treatment in Rabbit Models" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/35/8/1567" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Predicting the outcome of flow diversion treatment of cerebral aneurysms remains challenging. Our aim was to investigate the relationship between hemodynamic conditions created immediately after flow diversion and subsequent occlusion of experimental aneurysms in rabbits.

MATERIALS AND METHODS: The hemodynamic environment before and after flow-diversion treatment of elastase-induced aneurysms in 20 rabbits was modeled by using image-based computational fluid dynamics. Local aneurysm occlusion was quantified by using a voxelization technique on 3D images acquired 8 weeks after treatment. Global and local voxel-by-voxel hemodynamic variables were used to statistically compare aneurysm regions that later thrombosed to regions that remained patent.

RESULTS: Six aneurysms remained patent at 8 weeks, while 14 were completely or nearly completely occluded. Patent aneurysms had statistically larger neck sizes ( P = .0015) and smaller mean transit times ( P = .02). The velocity, vorticity, and shear rate were approximately 2.8 times ( P &lt; .0001) larger in patent regions—that is, they had larger “flow activity” than regions that progressed to occlusion. Statistical models based on local hemodynamic variables were capable of predicting local occlusion with good precision (84% accuracy), especially away from the neck (92%–94%). Predictions near the neck were poorer (73% accuracy).

CONCLUSIONS: These results suggests that the dominant healing mechanism of occlusion within the aneurysm dome is related to slow-flow-induced thrombosis, while near the neck, other processes could be at play simultaneously.

CFD
:   computational fluid dynamics
FD
:   flow-diverting
3DRA
:   3D rotational angiography" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J.R. Cebral</span>, <span class="highwire-citation-author" data-delta="1">F. Mut</span>, <span class="highwire-citation-author" data-delta="2">M. Raschi</span>, <span class="highwire-citation-author" data-delta="3">S. Hodis</span>, <span class="highwire-citation-author" data-delta="4">Y.-H. Ding</span>, <span class="highwire-citation-author" data-delta="5">B.J. Erickson</span>, <span class="highwire-citation-author" data-delta="6">R. Kadirvel</span> and <span class="highwire-citation-author" data-delta="7">D.F. Kallmes</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1567-1573; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3913 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-13582--8891431599" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J.R. Cebral </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Center for Computational Fluid Dynamics (J.R.C., F.M., M.R.), College of Sciences, George Mason University, Fairfax, Virginia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.R.%2BCebral%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Cebral%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.R.%2BCebral%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">F. Mut </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Center for Computational Fluid Dynamics (J.R.C., F.M., M.R.), College of Sciences, George Mason University, Fairfax, Virginia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BMut%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mut%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AF.%2BMut%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M. Raschi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Center for Computational Fluid Dynamics (J.R.C., F.M., M.R.), College of Sciences, George Mason University, Fairfax, Virginia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BRaschi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Raschi%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BRaschi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S. Hodis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (S.H., Y.-H.D., B.J.E., R.K., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BHodis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hodis%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BHodis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Y.-H. Ding </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (S.H., Y.-H.D., B.J.E., R.K., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.-H.%2BDing%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ding%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AY.-H.%2BDing%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">B.J. Erickson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (S.H., Y.-H.D., B.J.E., R.K., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.J.%2BErickson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Erickson%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AB.J.%2BErickson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">R. Kadirvel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (S.H., Y.-H.D., B.J.E., R.K., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BKadirvel%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kadirvel%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BKadirvel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">D.F. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">J.R. Cebral</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-2"><span class="name">F. Mut</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-3"><span class="name">M. Raschi</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-4"><span class="name">S. Hodis</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-5"><span class="name">Y.-H. Ding</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-6"><span class="name">B.J. Erickson</span><a id="xref-aff-2-3" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-7"><span class="name">R. Kadirvel</span><a id="xref-aff-2-4" class="xref-aff" href="#aff-2">b</a> and </li><li class="last" id="contrib-8"><span class="name">D.F. Kallmes</span><a id="xref-aff-2-5" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Center for Computational Fluid Dynamics (J.R.C., F.M., M.R.), College of Sciences, George Mason University, Fairfax, Virginia</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Departments of Radiology (S.H., Y.-H.D., B.J.E., R.K., D.F.K.)</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Neurosurgery (D.F.K.), Mayo Clinic, Rochester, Minnesota.</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Juan R. Cebral, PhD, <span class="addr-line">Center for Computational Fluid Dynamics, College of Sciences, George Mason University, 4400 University Dr, MSN 6A2, Fairfax, VA 22030</span>; e-mail: <span class="em-link"><span class="em-addr">jcebral{at}gmu.edu</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/35/8/1567.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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