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

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

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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Acknowledgements

This work is partly funded by the Federal Ministry of Education and Research within the Forschungscampus STIMULATE (13GW0095A, 13GW0095B) and the German Research Foundation (SA 3461/2-1, BE 6230/2-1).

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Authors and Affiliations

  1. Department of Simulation and Graphics, Otto-von-Guericke University Magdeburg, Universitätsplatz 2, 39106, Magdeburg, Germany

    Sylvia Saalfeld & Bernhard Preim

  2. Department of Fluid Dynamics and Technical Flows, Otto-von-Guericke University Magdeburg, Universitätsplatz 2, 39106, Magdeburg, Germany

    Samuel Voß & Philipp Berg

  3. University Hospital Magdeburg, Magdeburg, Germany

    Oliver Beuing

  4. Research Campus STIMULATE, Magdeburg, Germany

    Sylvia Saalfeld, Samuel Voß, Oliver Beuing, Bernhard Preim & Philipp Berg

Authors
  1. Sylvia Saalfeld
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  2. Samuel Voß
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  3. Oliver Beuing
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  4. Bernhard Preim
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  5. Philipp Berg
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Corresponding author

Correspondence to Sylvia Saalfeld.

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Ethic approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Conflict of interest

The authors Sylvia Saalfeld, Samuel Voß, Oliver Beuing, Bernhard Preim and Philipp Berg declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Saalfeld, S., Voß, S., Beuing, O. et al. Flow-splitting-based computation of outlet boundary conditions for improved cerebrovascular simulation in multiple intracranial aneurysms. Int J CARS 14, 1805–1813 (2019). https://doi.org/10.1007/s11548-019-02036-7

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  • DOI: https://doi.org/10.1007/s11548-019-02036-7

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