Simulation of intracranial aneurysm stenting: Techniques and challenges

Recently, there has been considerable interest in the use of stents as endovascular flow diverters for the treatment of intracranial aneurysms. Simulating this novel method of treatment is essential for understanding the intra-aneurysmal hemodynamics in order to design better stents and to personalize and optimize the endovascular stenting procedures. This paper describes a methodology based on unstructured embedded grids for patient-specific modeling of stented cerebral aneurysms, demonstrates how the methodology can be used to address specific clinical questions, and discusses remaining technical issues. In particular, simulations are presented on a number of patient-specific models constructed from medical images and using different stent designs and treatment alternatives. Preliminary sensitivity analyses with respect to stent positioning and truncation of the stent model are presented. The results show that these simulations provide useful and valuable information that can be used during the planning phase of endovascular stenting interventions for the treatment of intracranial aneurysms.