Patient-Specific Simulation of Carotid Artery Stenting Using Computational Fluid Dynamics

An image-based computational methodology to predict the outcome of carotid artery stenting procedures is presented. Anatomically realistic models are reconstructed from contrast-enhanced magnetic resonance angiography images using deformable models. Physiologic flow conditions are obtained from phase-contrast magnetic resonance angiography data. Finite element flow calculations are obtained before and after modifying the anatomical models in order to simulate stenting procedures. The methodology was tested on image data from a patient with carotid artery stenosis. Significant changes in the blood flow through the common carotid and internal carotid artery were found after conducting a "virtual stenting" intervention. Pending experimental validation, this methodology may potentially be used to plan and optimize vascular stenting procedures on a patient-specific basis.

[1]  Rainald Löhner,et al.  COMPUTER SIMULATION OF CEREBRAL ARTERY CLIPPING: RELEVANCE TO ANEURYSM NEURO-SURGERY PLANNING , 2000 .

[2]  B. Rutt,et al.  Hemodynamics of human carotid artery bifurcations: computational studies with models reconstructed from magnetic resonance imaging of normal subjects. , 1998, Journal of vascular surgery.

[3]  S. Berger,et al.  Flows in Stenotic Vessels , 2000 .

[4]  Thomas J. R. Hughes,et al.  Finite element modeling of blood flow in arteries , 1998 .

[5]  J. Connors,et al.  The nature of cervical carotid stenosis , 2000 .

[6]  R Löhner,et al.  Merging of intersecting triangulations for finite element modeling. , 2001, Journal of biomechanics.

[7]  J J Wentzel,et al.  Coronary stent implantation changes 3-D vessel geometry and 3-D shear stress distribution. , 2000, Journal of biomechanics.

[8]  J. Womersley Method for the calculation of velocity, rate of flow and viscous drag in arteries when the pressure gradient is known , 1955, The Journal of physiology.

[9]  Juan R. Cebral,et al.  An Implicit Monolithic Time Accurate Finite Element Scheme for Incompressible Flow Problems , 2001 .

[10]  C. Taylor,et al.  Predictive medicine: computational techniques in therapeutic decision-making. , 1999, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[11]  Rainald Loehner,et al.  New methods for computational fluid dynamics modeling of carotid artery from magnetic resonance angiography , 2001, SPIE Medical Imaging.

[12]  Peter L. Choyke,et al.  Vessel surface reconstruction with a tubular deformable model , 2001, IEEE Transactions on Medical Imaging.

[13]  A M Malek,et al.  Cerebral hyperperfusion syndrome after percutaneous transluminal stenting of the craniocervical arteries. , 2000, Neurosurgery.

[14]  A D Hughes,et al.  Blood flow and vessel mechanics in a physiologically realistic model of a human carotid arterial bifurcation. , 2000, Journal of biomechanics.

[15]  Juan R. Cebral,et al.  Flow visualization on unstructured grids using geometrical cuts, vortex detection and shock surfaces , 2001 .

[16]  Rainald Löhner,et al.  Automatic unstructured grid generators , 1997 .

[17]  R. Löhner Regridding Surface Triangulations , 1996 .

[18]  D Saloner,et al.  A numerical study of magnetic resonance images of pulsatile flow in a two dimensional carotid bifurcation: a numerical study of MR images. , 1998, Medical engineering & physics.