Análise in silico do escoamento hemodinâmico em aneurismas cerebrais do tipo basilar
Data
2016-08-26
Autores
Vieira, Edson Rodrigo Del Rio Vieira [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Segundo a Sociedade de Cirurgia Vascular da América do Norte e Sociedade Internacional de Cirurgia Cardiovascular, aneurismas são dilatações superiores ou iguais a 1,5 vezes o diâmetro original da artéria. Estima-se que aproximadamente 2% a 5% da população adulta tem algum tipo de aneurisma cerebral. Grande parte dos casos não chegam a causar sintomas ou gerar problemas graves, entretanto o risco de sua ruptura gera consequências clínicas desafiadoras, visto que tem grande taxa de morbimortalidade, tornando difícil a tarefa de tomar a decisão de intervenção ou não no tratamento do aneurisma. Neste trabalho, propõe-se o estudo numérico do escoamento em aneurismas do tipo basilar empregando-se a técnica da dinâmica de fluidos computacional. Comparando diferentes casos de aneurismas rompidos e não rompidos, identificamos características no escoamento para auxiliar a tomada de decisões no tratamento de pacientes. Os casos de aneurismas são oriundos de tomografias computadorizadas de pacientes reais, os quais foram utilizados para a criação dos modelos digitais. As simulações computacionais foram realizadas com oprogramaopen sourceOpenFOAM® . Outros programasopen source também foram utilizados na criação dos modelos, assim como para o tratamento dos resultados. Identificamos uma correlação entre os dados de tensão cisalhante na parede e a probabilidade de ruptura. Para os oito casos estudados, os resultados de previsão de ruptura e não ruptura apresentaram grande compatibilidade. Dentre os quatrocasos de aneurismas previamente reconhecidos como rompidos, trêsforam identificados pelas simulações comoaneurismas com alto risco de ruptura e umfoi identificado com risco intermediário de ruptura. Já para os quatro casos de aneurismas previamente reconhecidos como rompidos, doisforam identificados pelas simulações como aneurismas de baixo risco de ruptura e doiscom risco intermediário de ruptura.
According to the Society for Vascular Surgery of North America and the International Society of Cardiovascular Surgery, aneurysms are dilations greater than or equal to 1.5 times the original artery diameter.It is estimated that approximately 2% to 5% of adult population has some type of brain aneurysm. In most cases aneurysms are small enough not to cause symptoms or serious problems, however the risk of rupture generates challenging clinical consequences, since they have high rate of morbidity and mortality, making difficult the decision whether or not to treat the aneurysm. This work presents the study of the flow through the basilar type aneurysms using the technique of computational fluid dynamics. Comparing different cases of ruptured and nonruptured aneurysms, we identified some flow characteristics that can help in the decision making process for the treatment of patients. The cases studied were taken from CT scans of real patients, which were used for creation of digital models of aneurysm used in the simulations. The simulations were performed using open source software OpenFOAM® . Others open source softwares were also used in the creation of models as well as for post processing. We investigated the correlation between wall shear stress and the likelihood of rupture. For the eight cases, the rupture prediction results showed good correlation. For the four ruptured cases simulated, three were identified with high risk of rupture and one with intermediary risk of rupture. As for the four not ruptured cases, two were identified with low risk of rupture and two with intermediary risk of rupture.
According to the Society for Vascular Surgery of North America and the International Society of Cardiovascular Surgery, aneurysms are dilations greater than or equal to 1.5 times the original artery diameter.It is estimated that approximately 2% to 5% of adult population has some type of brain aneurysm. In most cases aneurysms are small enough not to cause symptoms or serious problems, however the risk of rupture generates challenging clinical consequences, since they have high rate of morbidity and mortality, making difficult the decision whether or not to treat the aneurysm. This work presents the study of the flow through the basilar type aneurysms using the technique of computational fluid dynamics. Comparing different cases of ruptured and nonruptured aneurysms, we identified some flow characteristics that can help in the decision making process for the treatment of patients. The cases studied were taken from CT scans of real patients, which were used for creation of digital models of aneurysm used in the simulations. The simulations were performed using open source software OpenFOAM® . Others open source softwares were also used in the creation of models as well as for post processing. We investigated the correlation between wall shear stress and the likelihood of rupture. For the eight cases, the rupture prediction results showed good correlation. For the four ruptured cases simulated, three were identified with high risk of rupture and one with intermediary risk of rupture. As for the four not ruptured cases, two were identified with low risk of rupture and two with intermediary risk of rupture.
Descrição
Palavras-chave
Bioengenharia, Simulação numérica, Aneurisma, Hemodinamica, CFD, Numerical simulation, Aneurysm, Basilar artery, Rupture