Journal Article

E-195 Hemodynamic changes in the anterior cerebral artery after flow diversion: proof-of-concept computational study

Srinivasan, V, A Wu, Scott, K, Lee, W, Lee, T, Davis, P

2025

Overview

BackgroundThis study analyzed hemodynamic changes in a single patient case following flow diverter-assisted coiling of an ICA bifurcation aneurysm. The stent was deployed toward the M1 segment of the MCA, jailing and reducing blood flow through the A1 segment of the ACA. Here, we used a computational fluid dynamics (CFD) algorithm to quantify ACA flow reduction post-stent deployment and assessed its hemodynamic implications proximally and in distal territories.MethodsAnalysis was conducted using Dr. NEAR flow (Seoul, KR), a software integrated from 3D reconstruction to cerebral vascular hemodynamics. CTA scans from a patient who underwent flow diverter stent placement were used to reconstruct a three-dimensional vascular model. A one-dimensional network model consisting of nodes and edges was generated to represent cerebral circulation (figure 1a). To simulate hemodynamic changes due to stent placement, the diameter of the first node at the ACA bifurcation was progressively reduced to mimic the decrease in cross-sectional area. This area was estimated by averaging the diameters of the first two bifurcation nodes. Using the software’s computational module, blood flow, pressure, and velocity were calculated assuming an ICA inflow of 3 mL/s, and their relationship to cross-sectional area reduction was analyzed.ResultsA 10% stepwise reduction in the first node diameter led to cross-sectional area decreases of 17%, 32%, 46%, and 58% (figure 1b). As cross-sectional area increased, ACA blood flow and pressure increased, while velocity decreased. These results suggest that changes in bifurcation from stent placement significantly impacted hemodynamics.ConclusionWithout knowing the exact stent porosity, we observed that a reduction in cross-sectional area at the ACA bifurcation decreased blood flow and pressure while increasing velocity in the jailed ACA segment. These findings suggest that stent placement alters hemodynamics, which could impact perfusion. Future studies should consider stent mesh design to predict postoperative hemodynamic changes, aiding surgical planning and outcome prediction based on deep learning processes with a clinical dataset.Abstract E-195 Figure 1DisclosuresA. Wu: None. W. Lee: 5; C; NEAR Brain, Inc.. P. Davis: None. K. Scott: None. T. Lee: 5; C; NEAR Brain, Inc. V. Srinivasan: 1; C; Zeiss, Siemens, Medtronic, Stryker. 2; C; Cerenovus, Stryker, Imperative Care, National Football League.

• Publisher: BMJ Publishing Group LTD
• Subject: Hemodynamics