Type
Text
Type
Dissertation
Advisor
Bluestein, Danny | Lieber, Baruch B | Qin, Yi-Xian | Fiorella, David.
Date
2015-05-01
Keywords
Biomedical engineering | Aneurysm, Angiography, Clinical, Flow-diverter, Hemodynamics, Stent
Department
Department of Biomedical Engineering.
Language
en_US
Source
This work is sponsored by the Stony Brook University Graduate School in compliance with the requirements for completion of degree.
Identifier
http://hdl.handle.net/11401/76982
Publisher
The Graduate School, Stony Brook University: Stony Brook, NY.
Format
application/pdf
Abstract
Nearly five percent of all strokes occur due to subarachnoid hemorrhage mostly due to the rupture of brain aneurysms. Treatment options of brain aneurysms include surgical clipping and endovascular embolization by deployment of intrasaccular coils to exclude the aneurysm from the circulation. Complicated fusiform, wide-necked, and large aneurysms are not amenable to surgical clipping or endovascular coiling. Flow diversion devices have evolved as an alternative treatment for such challenging cerebrovascular aneurysm. At Present, quantitative assessment of the efficacy of flow diversion at the time of treatment is not available. Clinicians estimate adequacy of treatment by visual inspection of contrast transport and its residence time within the aneurysm immediately post implantation. Quantitative parameters of contrast transport dynamics through the rabbit model of human brain aneurysm have shown correlation with long term treatment efficacy of flow diversion. Computational fluid dynamic simulations were employed in attempt to relate contrast transport to blood flow for medical device evaluation. This study evaluates flow diversion in idealized and patient based aneurysm geometries, in-vitro, in the rabbit aneurysm model as well as in human patients. In the rabbit model mathematical analysis of contrast washout and its correlation to the efficacy of flow diversion was conducted. Statistical analysis suggests that the analyzed parameters correlate with aneurysm occlusion however, significance was not reached due to a low sample size. Intra-aneurysmal hemodynamics CFD analysis was conducted in vitro through flow diverting devices flows as well as in 3 patients in addition to angiographic washout analysis in a larger cohort of patients that underwent flow diversion. Washout parameters such as contrast concentration decay time coefficient were in sync with intra-aneurysmal kinetic energy. Correlation of CFD analysis on the three patients to angiographic contrast washout indicate encouraging trend. This work also applied CFD and angiographic analysis to five commercially available neurovascular devices (not compared before). Geometry of the implanted devices in idealized brain aneurysm models was reconstructed from microCT images and applied to CFD analysis. The combination of experimental and computational approach provides initial data towards device inter-device evaluation of the efficacy of flow diverters for treatment of brain aneurysms. | 210 pages
Recommended Citation
Dholakia, Ronak Jashwant, "Evaluation of Flow Diverter Design and Efficacy of Flow Diversion through Angiographic and CFD Analysis" (2015). Stony Brook Theses and Dissertations Collection, 2006-2020 (closed to submissions). 2847.
https://commons.library.stonybrook.edu/stony-brook-theses-and-dissertations-collection/2847