Fast virtual deployment of self-expandable stents: Method and in vitro evaluation for intracranial aneurysmal stenting

• Published in: Medical image analysis 2012-04, Vol.16 (3), p.721-730
• Main Authors: Larrabide, Ignacio, Kim, Minsuok, Augsburger, Luca, Villa-Uriol, Maria Cruz, Rüfenacht, Daniel, Frangi, Alejandro F.
• Format: Article
• Language: English
• Subjects: Blood Vessel Prosthesis; Cerebral Angiography - methods; CFD; Humans; In vitro validation; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - surgery; Intracranial aneurysms; Pattern Recognition, Automated - methods; Prosthesis Implantation - methods; Radiographic Image Interpretation, Computer-Assisted - methods; Reproducibility of Results; Sensitivity and Specificity; Simplex deformable models; Stents; Surgery, Computer-Assisted - methods; Tomography, X-Ray Computed - methods; Virtual angiography; Virtual stenting
• ISSN: 1361-8415; 1361-8423
• DOI: 10.1016/j.media.2010.04.009

Minimally invasive treatment approaches, like the implantation of percutaneous stents, are becoming more popular every day for the treatment of intracranial aneurysms. The outcome of such treatments is related to factors like vessel and aneurysm geometry, hemodynamic conditions and device design. For this reason, having a tool for assessing stenting alternatives beforehand is crucial. The Fast Virtual Stenting (FVS) method, which provides an estimation of the configuration of intracranial stents when released in realistic geometries, is proposed in this paper. This method is based on constrained simplex deformable models. The constraints are used to account for the stent design. An algorithm for its computational implementation is also proposed. The performance of the proposed methodology was contrasted with real stents released in a silicone phantom. In vitro experiments were performed on the phantom where a contrast injection was performed. Subsequently, corresponding Computational Fluid Dynamics (CFD) analyzes were carried out on a digital replica of the phantom with the virtually released stent. Virtual angiographies are used to compare in vitro experiments and CFD analysis. Contrast time–density curves for in vitro and CFD data were generated and used to compare them. Results of both experiments resemble very well, especially when comparing the contrast density curves. The use of FVS methodology in the clinical environment could provide additional information to clinicians before the treatment to choose the therapy that best fits the patient.