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International Journal of Computer Assisted Radiology and Surgery

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01-10-2019 | Intracranial Aneurysm | Original Article

Flow-splitting-based computation of outlet boundary conditions for improved cerebrovascular simulation in multiple intracranial aneurysms

Authors: Sylvia Saalfeld, Samuel Voß, Oliver Beuing, Bernhard Preim, Philipp Berg

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 10/2019

Abstract

Purpose

Image-based hemodynamic simulations have great potential for precise blood flow predictions in intracranial aneurysms. Due to model assumptions and simplifications with respect to boundary conditions, clinical acceptance remains limited.

Methods

Within this study, we analyzed the influence of outflow-splitting approaches on multiple aneurysm studies and present a new outflow-splitting approach that takes the precise morphological vessel cross sections into account. We provide a detailed comparison of five outflow strategies considering eight intracranial aneurysms: zero-pressure configuration (1), a flow splitting inspired by Murray’s law with a square (2) and a cubic (3) vessel diameter, a flow splitting incorporating vessel bifurcations based on circular vessel cross sections (4) and our novel flow splitting including vessel bifurcations and anatomical vessel cross sections (5). Other boundary conditions remain constant. For each simulation and each aneurysm, we conducted an evaluation based on common hemodynamic parameters, e.g., normalized wall shear stress and inflow concentration index.

Results

The comparison of five outflow strategies for image-based simulations shows a large variability regarding the parameters of interest. Qualitatively, our strategy based on anatomical cross sections yields a more uniform flow rate distribution with increased aneurysm inflow rates. The commonly used zero-pressure approach shows the largest variations, especially for more distal aneurysms. A rank ordering of multiple aneurysms in one patient might still be possible, since the ordering appeared to be independent of the outflow strategy.

Conclusions

The results reveal that outlet boundary conditions have a crucial impact on image-based blood flow simulations, especially for multiple aneurysm studies. We could confirm the advantages of the more complex outflow-splitting model (4) including an incremental improvement (5) compared to strategies (1), (2) and (3) for this application scenario. Furthermore, we discourage from using zero-pressure configurations that lack a physiological basis.

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Title: Flow-splitting-based computation of outlet boundary conditions for improved cerebrovascular simulation in multiple intracranial aneurysms
Authors: Sylvia Saalfeld
Samuel Voß
Oliver Beuing
Bernhard Preim
Philipp Berg
Publication date: 01-10-2019
Publisher: Springer International Publishing
Keywords: Intracranial Aneurysm
Aneurysm
Aneurysm
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 10/2019
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-019-02036-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Flow-splitting-based computation of outlet boundary conditions for improved cerebrovascular simulation in multiple intracranial aneurysms

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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