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Numerical Simulation of the Blood Flow through a Brain Vascular Aneurysm with an Artificial Stent Using the SPH Method

We present numerical simulations of blood flow through a brain vascular aneurysm with an artificial stent using Smoothed Particle Hydrodynamics (SPH). The aim of this work is to analyze how the flow into an aneurysm changes using different stent configurations. The initial conditions for the simulations were constructed from angiographic images of a real patient with an aneurysm. The wall shear stresses, pressure and highest velocity within the artery, and other particular quantities are calculated which are of medical specific interest. The numerical simulations of the cerebral circulation help doctors to determine if the patient’s own vascular anatomy has the conditions to allow arterial stenting by endovascular method before the surgery or even evaluate the effect of different stent structure and materials. The results show that the flow downstream the aneurysm is highly modified by the stent configuration and that the best choice for reducing the flow in the aneurysm is to use a completely extended Endeavor stent.

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Introduction: Atrial fibrillation (AF) is the most common sustained cardiac rhythm abnormality. AF treatment is provided by either cardiologists or non-cardiologists and is based on the prevention of thromboembolic events and on heart rate control or rhythm control. There is evidence that AF management by specialists leads to improved patient outcomes. Moreover, management of complex cardiac arrhythmias by a specialized team has been considered helpful by an overwhelming majority of practicing physicians. Therefore, we designed a multidisciplinary team – Fast Approach by a Specialized Team for Atrial Fibrillation (FAST-AF) – to evaluate the treatment effectiveness of a specialized arrhythmia team compared to the standard of care in the management of patients with new-onset AF presenting in the emergency department (ED).

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The results described in this work are part of a larger project. The long term goal of this project is to help physicians predict the hemodynamic changes, and associated risks, caused by different treatment options for brain arteriovenous malformations. First, we need to build a model of the vascular architecture of each specific patient. Our approach to build these models is described in this work. Later we will use the model of the vascular architecture to simulate the velocity and pressure gradients of the blood flowing within the vessels, and the stresses on the blood vessel walls, before and after treatment. We are developing a computer program to describe each blood vessel as a parametric curve, where each point within this curve includes a normal vector that points in the opposite direction of the pressure gradient. The shape of the cross section of the vessel in each point is described as an ellipse. Our program is able to describe the geometry of a blood vessel using as an input a cloud of dots. The program allows us to model any blood vessel, and other tubular structures.

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