The Effect of 3D Visualization on Optimal Design for Strut Position of Intracranial Stent Available to Purchase

Cerebral aneurysms generally occur at arterial bifurcations and arterial curves in or near the circle of Willis. For the treatment of this disorder, stent placement has been valued as a minimal invasive therapy. The effect of stents on flow reduction in cerebral aneurysms has been examined in several computed fluid dynamics (CFD) studies, suggesting that the stent position or the strut shape may affect flow reduction. However, the position of the stent with the best effect on flow reduction is still unknown because of the flow complexity. Three-dimensional visualization may help to easily specify the inflow zone from the parent artery to the aneurysm and to find the relationship between the effective strut position and the flow pattern. However, confirmation of the ability of 3D visualization to determine the effective position of a stent has not been achieved. In this study, we simulated blood flow with several aneurysm geometries to confirm the effect of 3D visualization on determination of optimal stent position. First, flow simulation using real aneurysm geometries without a stent was performed as a “pre-stenting situation.” Meshes were generated using a commercial code (Gambit 2.3, Fluent Inc., NH). CFD was carried out using a commercial code (Fluent 6.3, Fluent Inc., NH) based on steady flow. The streamlines around an aneurysm were visualized using a 3D visualization system (EnSight Gold 8.2, Comuputational Engineering Inc., NC) in Realization Workspace (RWS) to visualize the inflow zone. Secondly, a rectangular solid as a strut model was set in the inflow zone using computer-aided design (CAD) techniques. CFD was then performed as a “post-stenting situation” under the same conditions as the pre-stenting situation using the same mesh generator and CFD code. Three-dimensional visualization showed an inflow zone in the aneurysm. A bundle of flow streamlines hit the wall of the neck of the aneurysm and entered it. The inflow zone was a narrow local part in contrast to the outflow. After setting a strut, a change of flow pattern could be observed. The flow speed and the wall shear stress (WSS) were both reduced. When the strut position was moved away from the original position, the flow speed and the WSS were not reduced. These results may suggest that 3D visualization can provide information useful for strut positioning to realize effective reduction of flow into an aneurysm, especially a side wall aneurysm.