• Onur Mutlu, Ali Bahadır Olcay, Cem Bilgin, and Bahattin Hakyemez.
• Faculty of Engineering, Department of Mechanical Engineering, Yeditepe University, Kayisdagi Cad, Istanbul, Turkey.
• World Neurosurg. 2019 Jul 1; 127: e727-e737.

BackgroundFlow diverter stents are often used in the treatment of giant aneurysms at carotid arteries. Although these stents promise to decrease blood flow into the aneurysm sac, little is known about hemodynamics inside the aneurysm once the stent is planted into the aneurysm neck. To further explore this, computational fluid dynamics and Lagrangian coherent structure (LCS) techniques were used to evaluate the time evolution mechanism of stagnation regions inside an aneurysm. The purpose of this work is to provide a quantitative effectiveness comparison of 2 different flow diverter stents placed into the aneurysm neck based on their stagnation zone formations in the sac.MethodsIn numerical modeling, Womersley function, and fluidsolid interaction were defined as the 3 cardiac cycles for blood velocity and the aneurysm wall, respectively. Moreover, blood was accepted as a non-Newtonian fluid, and mean arterial blood pressure of the patient was entered into the computational domain to accurately mimic the hemodynamics inside the aneurysm sac accurately.ResultsThe numerical analyses revealed that the use of a Fred-type stent in the aneurysm neck causes fluid flow zone formations yielding to sequenced stagnated regions. Time evolution of stagnation regions in an aneurysm sac was shown just after a flow diverter stent was employed at a patient's aneurysm neck. Furthermore, the stagnation field in the Fred stent-fitted aneurysm was nearly 4.8 times the stagnation area of the Surpass brand stent-attached aneurysm.ConclusionsFinite time Lyapunov exponent fields obtained from the LCS techniques demonstrated a good agreement with the patient's digital subtraction angiography images obtained just after treatment.Copyright © 2019 Elsevier Inc. All rights reserved.

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