The role of blood flow in aneurysm pathophysiology and treatment - @neurIST, Physiome - voxel,...
-
Upload
kristin-parsons -
Category
Documents
-
view
220 -
download
0
Transcript of The role of blood flow in aneurysm pathophysiology and treatment - @neurIST, Physiome - voxel,...
The role of blood flow in aneurysm pathophysiology and treatment
- @neurIST, Physiome- voxel, pixel, phyxel, bioxel- flow in aneurysms- flow in the intracranial compartment- homeostasis, allostasis
www.neuroimaging.ch
STEP 15 / 16.5.2006 - a strategy for the EUORPHYSIOME - FP7
PixelPicture (Pics, Pix) and element
VoxelVolume and pixel(spatial aspects)
Bioxel (biological element)integration of allbiological and physical parameters allowing for modelling of life in a virtual environment to understandhomeostasic and allostasic mechanismsof biological systems
Phyxel (physical element)
4D - pixel (temporal aspects)
RealHuman
VirtualReplicaof Human
Converging technologies
Mission statement:
@neurIST will develop an IT infrastructure for the management and processing of heterogeneous data associated with the diagnosis and treatment of cerebral aneurysm and subarachnoid haemorrhage. The data span all length scales, from molecular, through cellular to tissue, organ and patient representations. These data are increasingly heterogeneous in form, including textual, image and other symbolic structures, and are also diverse in context, from global guidelines based on the broadest epidemiological studies, through knowledge gained from disease-specific scientific studies, to patient-specific data from electronic health records. New methods are required to manage, integrate and interrogate the breadth of data and to present it in a form that is accessible to the end user. FP6http://aneurist.org
Initiation
GrowthRupture
Humphrey JDCardiovascular solid mechanics2001
2-4%2000-4000/100K
10/100K/y
Humphrey JDCardiovascular solid mechanics2001
@neuEndoWCE – ANSYS
IDAC – ASD
@neuRiskINF - PMS
How will the results precisely impact on the targeted groups?
Improve decision making processes in the management of unruptured aneurysms by providing a score that integrates all the available information for identifying at-risk patients and reducing current over treatment
Support computational design processes towards a next generation of smart flow-correcting implants to treat ruptured aneurysms and reduce current treatment costs, side effects and recurrence.
Support the knowledge discovery for linking genetics to disease, vasospasm and blood clotting after cerebral hemorrhage
@neurISTSystems
WSS
3DRA
CFDCFD
PC-MR vs USFlow rates
CFD vs USPeak velocity
Model& WSS
magnitude phasemagnitude phase
Support the integration of modeling, simulation and visualization of multimodal data
@neuCompute/InfoNEC – GS – ANSYS
Support integration of data and computing resources.
@neuFuseB3C – PMS
Supp
ort T
ools
Enab
ling
IT
@neuLinkSCAI (Roche, Actelion)
BalloonAneurysm
Filling
Coil Aneurysm
Filling
Stent-AssistedCoiling
Flow DiversionVessel Repair
1985 1990 2005 2010
Cebral JR, Putman C - G. Mason Univ., Fairfax, VA
Image guided minimal invasive treatment methods:Endovascular repair of cerebral arteries based on 3D imaging data: Converging Technologies
MedicalImaging
3D dataset
DSA,MR,CT
Patient
database
Treatment
control
Medical
Informatics,
Flow-/ Wall-
Biomech.
Simulation- Validation (numeric,
in-vitro, …)
CFD
PIV / LDV
Flow-correction
Rupture risk
assessment;
Stent design CAD
MedicalDevice
Stent
material
Stent
delivery
Stent
Treatment
outside wall inside
perianeurismal
environment
tissue, shape,
biomechanics
blood flow
rheology
Weir B
Autoregulation: Flow in collapsible veins - CBF Autoregulation: Flow in collapsible veins - CBF
1. Increased ICP increases outflow obstruction
2. The vascular resistance of the microvascularbed decreases at increased ICP (within certain limits)
• Venous autoregulation of global CBF
D Greitz: Int J Neurorad 1997
1.
2.
Autoregulation of CBF and CSF (Homeostasis)Autoregulation of CBF and CSF (Homeostasis)
1. Homeostasis (“stability through constancy”) of brain and CSF circulation can adapt to parameter changes in a limited range.
2. Under pathological conditions such as Trauma, Hemorrhage, Thrombosis, Ischemia, etc. the homeostatic mechanisms are unable to cope with the demands placed on them (acutely, chronically).
3. Allostasis (“stability through change”) allows for reaching conditions of a new balance in such pathological conditions (“fitness under natural selection”).
4. Only numerical simulation may help to understand such complex conditions and suggest ways of medical therapy, i.e. corrections that may lead to a new equilibrium for a system in trouble.
P Sterling: Principles of allostasis, 2004