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Description
A cerebral aneurysm is a bulging of a blood vessel in the brain. Aneurysmal rupture affects 25,000 people each year and is associated with a 45% mortality rate. Therefore, it is critically important to treat cerebral aneurysms effectively before they rupture. Endovascular coiling is the most effective treatment for cerebral

A cerebral aneurysm is a bulging of a blood vessel in the brain. Aneurysmal rupture affects 25,000 people each year and is associated with a 45% mortality rate. Therefore, it is critically important to treat cerebral aneurysms effectively before they rupture. Endovascular coiling is the most effective treatment for cerebral aneurysms. During coiling process, series of metallic coils are deployed into the aneurysmal sack with the intent of reaching a sufficient packing density (PD). Coils packing can facilitate thrombus formation and help seal off the aneurysm from circulation over time. While coiling is effective, high rates of treatment failure have been associated with basilar tip aneurysms (BTAs). Treatment failure may be related to geometrical features of the aneurysm. The purpose of this study was to investigate the influence of dome size, parent vessel (PV) angle, and PD on post-treatment aneurysmal hemodynamics using both computational fluid dynamics (CFD) and particle image velocimetry (PIV). Flows in four idealized BTA models with a combination of dome sizes and two different PV angles were simulated using CFD and then validated against PIV data. Percent reductions in post-treatment aneurysmal velocity and cross-neck (CN) flow as well as percent coverage of low wall shear stress (WSS) area were analyzed. In all models, aneurysmal velocity and CN flow decreased after coiling, while low WSS area increased. However, with increasing PD, further reductions were observed in aneurysmal velocity and CN flow, but minimal changes were observed in low WSS area. Overall, coil PD had the greatest impact while dome size has greater impact than PV angle on aneurysmal hemodynamics. These findings lead to a conclusion that combinations of treatment goals and geometric factor may play key roles in coil embolization treatment outcomes, and support that different treatment timing may be a critical factor in treatment optimization.
ContributorsIndahlastari, Aprinda (Author) / Frakes, David (Thesis advisor) / Chong, Brian (Committee member) / Muthuswamy, Jitendran (Committee member) / Arizona State University (Publisher)
Created2013
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Description
A specific type of Congenital Heart Defect (CHD) known as Coarctation (narrowing) of the Aorta (CoA) prevails in 10% of all CHD patients resulting in life-threatening conditions. Treatments involve limited medical therapy (i.e PGE1 therapy), but in majority of CoA cases, planned surgical treatments are very common. The surgical approach

A specific type of Congenital Heart Defect (CHD) known as Coarctation (narrowing) of the Aorta (CoA) prevails in 10% of all CHD patients resulting in life-threatening conditions. Treatments involve limited medical therapy (i.e PGE1 therapy), but in majority of CoA cases, planned surgical treatments are very common. The surgical approach is dictated by the severity of the coarctation, by which the method of treatments is divided between minimally invasive and extensive invasive procedures. Modern diagnostic procedures allude to many disadvantages making it difficult for clinical practices to properly deliver an optimal form of care. Computational Fluid Dynamics (CFD) technique addresses these issues by providing new forms of diagnostic measures that is non-invasive, inexpensive, and more accurate compared to other evaluative devices. To explore further using the CFD based alternative diagnostic measure, this project aims to validate CFD techniques through in vitro studies that capture the fluid flow in anatomically accurate aortic structures. These studies combine particle image velocimetry and catheterization experimental techniques in order to provide a significant knowledge towards validation of fluid flow simulations.
ContributorsPathangey, Girish (Co-author) / Matheny, Chris (Co-author) / Frakes, David (Thesis director) / Pophal, Stephen (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2015-05
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Description
Intracranial aneurysms are blood \u2014filled sacs along the blood vessels in the brain. These aneurysms can be particularly dangerous due to difficulty in detection and potential lifethreatening outcome. When these aneurysms are detected, there are few treatment options to prevent rupture, one of which is endovascular stents. By placing a

Intracranial aneurysms are blood \u2014filled sacs along the blood vessels in the brain. These aneurysms can be particularly dangerous due to difficulty in detection and potential lifethreatening outcome. When these aneurysms are detected, there are few treatment options to prevent rupture, one of which is endovascular stents. By placing a stent across the parent vessel, blood flow can be diverted from the aneurysm. Reduced flow reduces the chance of rupture and promotes clotting within the aneurysm. In this study, hemodynamics in idealized basilar tip aneurysm models were investigated at three flow rates using particle imaging velocimetry (PIV). Two models were created with increasing dome size (4mm vs 6mm), and constant dome-to-neck ratio (3:2) and parent vessel contact angle to represent growing aneurysm. With the pulsatile flow, data is acquired at three separate points in the cardiac cycle. Both of the models were studied untreated, treated with Enterprise stent and treated with Pipeline stent. Enterprise stent was developed mainly for structural support while the Pipeline stent was developed as a flow diverter. Due to target functions of the stents, Enterprise stent is more porous than the Pipeline stent. Hemodynamics were studied using a stereo particle image velocimetry technique. The flow in models was characterized by neck and aneurysmal RMS velocity, neck and aneurysm kinetic energy, cross neck flow. It was found that both of the stents are capable diverting flow. Enterprise reduced aneurysmal RMS velocity in model 1 by 38.7% and in model 2 by 76.2%. Pipeline stent reduced aneurysmal RMS velocity in model 1 by 71.4% and in model 2 by 88.1%. Both reductions are data for 3ml/s at peak systole pulsatile flow. Data shows that the Pipeline stent is better than Enterprise stent at reducing flow to the aneurysm.
ContributorsChung, Hanseung (Author) / Frakes, David (Thesis director) / Caplan, Michael (Committee member) / Babiker, Haithem (Committee member) / Barrett, The Honors College (Contributor) / Economics Program in CLAS (Contributor) / Harrington Bioengineering Program (Contributor)
Created2014-05
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Description
Intracranial aneurysms, which form in the blood vessels of the brain, are particularly dangerous because of the importance and fragility of the human brain. When an intracranial aneurysm gets large it poses a significant risk of bursting and causing subarachnoid hemorrhaging (SAH), a possibly fatal condition. One possible treatment involves

Intracranial aneurysms, which form in the blood vessels of the brain, are particularly dangerous because of the importance and fragility of the human brain. When an intracranial aneurysm gets large it poses a significant risk of bursting and causing subarachnoid hemorrhaging (SAH), a possibly fatal condition. One possible treatment involves placing a stent in the vessel to act as a flow diverter. In this study we look at the hemodynamics of two geometries of idealized basilar tip aneurysms, at 2,3, and 4 ml/s pulsatile flow, at three different points in the cardiac cycle. The smaller model had neck and dome diameters of 2.67 mm and 4 mm respectively, while the larger aneurysm had neck and dome diameters of 3 mm and 6 mm respectively. Both diameters and the dome to neck ratio increased in the second model, representing growth over time. Flow was analyzed using stereoscopic particle image velocimetry (PIV) for both geometries in untreated models, as well as after treatment with a high porosity Enterprise stent (Codman and Shurtleff Inc.). Flow in the models was characterized by root mean square velocity in the aneurysm and neck plane, cross neck flow, max aneurysm vorticity, and total aneurysm kinetic energy. It was found that in the smaller aneurysm model (model 1), Enterprise stent treatment reduced all flow parameters substantially. The smallest reduction was in max vorticity, at 42.48%, and the largest in total kinetic energy, at 75.69%. In the larger model (model 2) there was a 52.18% reduction in cross neck flow, but a 167.28% increase in aneurysm vorticity. The other three parameters experienced little change. These results, along with observed velocity vector fields, indicate a noticeable diversion of flow away from the aneurysm in the stent treated model 1. Treatment in model 2 had a small flow diversion effect, but also altered flow in unpredictable ways, in some cases having a detrimental effect on aneurysm hemodynamics. The results of this study indicate that Enterprise stent treatment is only effective in small, relatively undeveloped aneurysm geometries, and waiting until an aneurysm has grown too large can eliminate this treatment option altogether.
ContributorsLindsay, James Bryan (Author) / Frakes, David (Thesis director) / LaBelle, Jeffrey (Committee member) / Nair, Priya (Committee member) / Barrett, The Honors College (Contributor) / School of Humanities, Arts, and Cultural Studies (Contributor)
Created2013-05