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. 2023 Jun;14(3):393-403.
doi: 10.1007/s13239-023-00660-8. Epub 2023 Feb 22.

Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup

C A Luisi  1 , A Amiri  1 , M Büsen  1 , T Sichermann  2 , O Nikoubashman  2 , M Wiesmann  2 , U Steinseifer  1 , M Müller  2 , M Neidlin  3
Affiliations

Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup

C A Luisi et al. Cardiovasc Eng Technol. 2023 Jun.

Abstract

Purpose: Acute ischemic stroke is a life-threatening emergency caused by an occlusion of a cerebral artery through a blood clot. Aspiration thrombectomy is an endovascular therapy for the removal of vessel occlusions. However, open questions regarding the hemodynamics during the intervention remain, motivating investigations of blood flow within cerebral arteries. In this study, we present a combined experimental and numerical approach to analyze hemodynamics during endovascular aspiration.

Methods: We have developed an in vitro setup for investigations of hemodynamic changes during endovascular aspiration within a compliant model of patient-specific cerebral arteries. Pressures, flows, and locally resolved velocities were obtained. In addition, we established a computational fluid dynamics (CFD) model and compared the simulations during physiological conditions and in two aspiration scenarios with different occlusions.

Results: Flow redistribution within cerebral arteries after ischemic stroke is strongly dependent on the severity of the occlusion and on the volume flow extracted by endovascular aspiration. Numerical simulations exhibit an excellent correlation of R = 0.92 for flow rates and a good correlation of R = 0.73 for pressures. Further on, the local velocity field inside the basilar artery had a good agreement between CFD model and particle image velocimetry (PIV) data.

Conclusion: The presented setup allows for in vitro investigations of artery occlusions and endovascular aspiration techniques on arbitrary patient-specific cerebrovascular anatomies. The in silico model provides consistent predictions of flows and pressures in several aspiration scenarios.

Keywords: Aspiration thrombectomy; Cerebral artery model; Cerebral blood flow; Computational fluid dynamics; Particle image velocimetry.

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Conflict of interest statement

All of the authors have nothing to disclose.

Figures

Figure 1
Figure 1
Scheme of the experimental setup. Ac aspiration catheter, DAQ data acquisition.
Figure 2
Figure 2
Example of the process from designed to manufactured silicone model. (a) CTA-data based segmented model with adaptation at inlet and outlet, (b) printed ABS core, (c) hollow, flexible silicone model (d) CFD model of the CoW with inlets and outlets.
Figure 3
Figure 3
(a) Image of the experimental setup with cerebral artery model. (b) Vessel occlusion and aspiration catheter.
Figure 4
Figure 4
Schematic view of flow scenarios. Thrombus visualized by black cross. PIV measurement windows shown by dotted frame. (a) physiological scenario. (b) and (c) A T-occlusion with aspiration catheter. (b)—no aspiration, (c)—aspiration of 100 mL/min. (d) An LMCA occlusion with aspiration catheter and an aspiration of 100 mL/min.
Figure 5
Figure 5
Flows and pressures for scenarios (a–d). The flow rates are normalized by the total outflow, (a)—614 mL/min, (b)—554 mL/min, (c)—616 mL/min and (d)—652 mL/min.
Figure 6
Figure 6
Scatterplots of flows and pressures for all scenarios. Comparison of computational and experimental data with Pearson correlation. The dashed ellipse shows the outliers belonging to RPCA. Red line from linear regression.
Figure 7
Figure 7
BA field in-plane velocities, (a) Scenario A acquired via PIV, (b) Scenario A calculated via CFD.
See this image and copyright information in PMC

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