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Article ; Online: Hemodynamic and morphological differences in cerebral aneurysms between before and after rupture.

Fujimura, Soichiro / Yamanaka, Yuma / Takao, Hiroyuki / Ishibashi, Toshihiro / Otani, Katharina / Karagiozov, Kostadin / Fukudome, Koji / Yamamoto, Makoto / Murayama, Yuichi

Journal of neurosurgery

2023 Volume 140, Issue 3, Page(s) 774–782

Abstract: Objective: Although it has been proposed that aneurysm morphology is different after rupture, detailed research of the morphological changes using 3D imaging acquired before and after rupture has not been conducted because of the difficulty of data ... ...

Abstract	Objective: Although it has been proposed that aneurysm morphology is different after rupture, detailed research of the morphological changes using 3D imaging acquired before and after rupture has not been conducted because of the difficulty of data collection. Similarly, hemodynamic changes due to morphological alterations after rupture have not been analyzed. The aim of this study was to investigate the changes in morphology and hemodynamics observed after aneurysm rupture. Methods: For 21 cerebral aneurysms (21 patients) that ruptured during observation, 3D geometry of the aneurysms and parent arteries were reconstructed based on the angiographic images before and after their rupture. In addition, using the reconstructed geometry, blood flow was simulated by computational fluid dynamics (CFD) analysis. Morphological and hemodynamic parameters were calculated both before and after rupture, and their changes from before to after were compared. Results: In the morphological parameters, statistically significantly higher values were observed after rupture in height (before: 5.5 ± 2.1 mm, after: 6.1 ± 2.0 mm; p < 0.0001), aspect ratio (p = 0.002), aneurysm volume (p = 0.04), and undulation index (p = 0.005). In terms of hemodynamic changes, the mean normalized wall shear stress (NWSS) decreased significantly (before: 5.4 × 10-1 ± 2.9 × 10-1, after: 4.4 × 10-1 ± 2.8 × 10-1; p < 0.001) as well as the other NWSS parameters, including maximum and minimum NWSS, which were associated with stagnant flow due to the morphological changes after rupture. Conclusions: Aneurysm morphology was found to change after rupture into an elongated and irregular geometry, accompanied by an increase in aneurysm volume. These morphological changes were also associated with statistically significant hemodynamic alterations that produced low wall sheer stress by stagnant flow. The authors' results also provide the opportunity to explore and develop a risk evaluation method for aneurysm rupture based on prerupture morphology and hemodynamics by further exploration in this direction.
MeSH term(s)	Humans ; Intracranial Aneurysm/diagnostic imaging ; Hemodynamics ; Aneurysm, Ruptured/diagnostic imaging ; Angiography ; Arteries
Language	English
Publishing date	2023-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2023.6.JNS23289
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Article ; Online: Development of Machine Learning Model for Selecting the 1st Coil in the Treatment of Cerebral Aneurysms by Coil Embolization.

Fujimura, Soichiro / Koshiba, Toshiki / Kudo, Genki / Takeshita, Kohei / Kazama, Masahiro / Karagiozov, Kostadin / Fukudome, Koji / Takao, Hiroyuki / Ohwada, Hayato / Murayama, Yuichi / Yamamoto, Makoto / Ishibashi, Toshihiro / Otani, K

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

2023 Volume 2023, Page(s) 1–4

Abstract: To achieve good treatment outcomes in coil embolization for cerebral aneurysms, it is important to select an appropriate 1st coil for each aneurysm since it serves as a frame to support the subsequent coils to be deployed. However, its selection as ... ...

Abstract	To achieve good treatment outcomes in coil embolization for cerebral aneurysms, it is important to select an appropriate 1st coil for each aneurysm since it serves as a frame to support the subsequent coils to be deployed. However, its selection as appropriate size and length from a wide variety of lineups is not easy, especially for inexperienced neurosurgeons. We developed a machine learning model (MLM) to predict the optimal size and length of the 1st coil by learning information on patients and aneurysms that were previously treated with coil embolization successfully. The accuracy rates of the MLM for the test data were 86.3% and 83.4% in the prediction of size and length, respectively. In addition, the accuracy rates for the 30 cases showed good prediction by the MLM when compared with two different skilled neurosurgeons. Although the accuracy rate of the well-experienced neurosurgeon is similar to MLM, the inexperienced neurosurgeon showed a worse rate and can benefit from the method.Clinical Relevance- The developed MLM has the potential to assist in the selection of the 1st coil for aneurysms. A technically and cost efficient supply chain in the treatment of aneurysms may also be achieved by MLM application.
MeSH term(s)	Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/therapy ; Embolization, Therapeutic/adverse effects ; Treatment Outcome ; Blood Vessel Prosthesis
Language	English
Publishing date	2023-12-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2694-0604
ISSN (online)	2694-0604
DOI	10.1109/EMBC40787.2023.10341191
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Article ; Online: Computational Experiments on the Step and Frequency Responses of a Three-Axis Thermal Accelerometer.

Ogami, Yoshifumi / Murakita, Naoya / Fukudome, Koji

Sensors (Basel, Switzerland)

2017 Volume 17, Issue 11

Abstract: The sensor response has been reported to become highly nonlinear when the acceleration added to a thermal accelerator is very large, so the same response can be observed for two accelerations with different magnitudes and opposite signs. Some papers have ...

Abstract	The sensor response has been reported to become highly nonlinear when the acceleration added to a thermal accelerator is very large, so the same response can be observed for two accelerations with different magnitudes and opposite signs. Some papers have reported the frequency response for the horizontal acceleration to be a first-order system, while others have reported it to be a second-order system. The response for the vertical acceleration has not been studied. In this study, computational experiments were performed to examine the step and frequency responses of a three-axis thermal accelerometer. The results showed that monitoring the temperatures at two positions and making use of cross-axis sensitivity allow a unique acceleration to be determined even when the range of the vertical acceleration is very large (e.g., -10,000-10,000 g). The frequency response was proven to be a second-order system for horizontal acceleration and a third-order system for vertical acceleration.
Language	English
Publishing date	2017-11-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s17112618
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Article ; Online: Development of a Virtual Stent Deployment Application to Estimate Patient-Specific Braided Stent Sizes.

Fujimura, Soichiro / Kan, Issei / Takao, Hiroyuki / Uchiyama, Yuya / Ishibashi, Toshihiro / Otani, Katharina / Fukudome, Koji / Murayama, Yuichi / Yamamoto, Makoto

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

2021 Volume 2021, Page(s) 4184–4187

Abstract: A virtual stent deployment application was developed to estimate the appropriate and patient-specific size of a braided stent for patients who undergo endovascular treatment for intracranial aneurysms. Comparing between the simulated deployed and the ... ...

Abstract	A virtual stent deployment application was developed to estimate the appropriate and patient-specific size of a braided stent for patients who undergo endovascular treatment for intracranial aneurysms. Comparing between the simulated deployed and the actual stents, we evaluated the accuracy of the simulation results. Our results indicated that lengths of the virtual and actual stents matched well despite the actual stent being affected by a geometrical change of the parent artery.Clinical Relevance-Surgeons need to be well-experienced to select an appropriate braided stent size for endovascular treatment of intracranial aneurysms, because the actual length of the deployed stent changes. This simulation will be helpful to make tailor-made surgical planning regardless of the surgeons' individual skill level.
MeSH term(s)	Computer Simulation ; Humans ; Intracranial Aneurysm/surgery ; Stents
Language	English
Publishing date	2021-12-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2694-0604
ISSN (online)	2694-0604
DOI	10.1109/EMBC46164.2021.9629928
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Article: Hemodynamic Investigation of the Effectiveness of a Two Overlapping Flow Diverter Configuration for Cerebral Aneurysm Treatment.

Uchiyama, Yuya / Fujimura, Soichiro / Takao, Hiroyuki / Suzuki, Takashi / Hayakawa, Motoharu / Ishibashi, Toshihiro / Karagiozov, Kostadin / Fukudome, Koji / Murayama, Yuichi / Yamamoto, Makoto

Bioengineering (Basel, Switzerland)

2021 Volume 8, Issue 10

Abstract: Flow diverters (FDs) are widely employed as endovascular treatment devices for large or wide-neck cerebral aneurysms. Occasionally, overlapped FDs are deployed to enhance the flow diversion effect. In this study, we investigated the hemodynamics of ... ...

Abstract	Flow diverters (FDs) are widely employed as endovascular treatment devices for large or wide-neck cerebral aneurysms. Occasionally, overlapped FDs are deployed to enhance the flow diversion effect. In this study, we investigated the hemodynamics of overlapping FDs via computational fluid dynamics (CFD) simulations. We reproduced the arterial geometry of a patient who had experienced the deployment of two overlapping FDs. We utilized two stent patterns, namely the patterns for one FD and two overlapping FDs. We calculated the velocity, mass flow rate, wall shear stress, and pressure loss coefficient as well as their change rates for each pattern relative to the no-FD pattern results. The CFD simulation results indicated that the characteristics of the blood flow inside the aneurysm were minimally affected by the deployment of a single FD; in contrast, the overlapping FD pattern results revealed significant changes in the flow. Further, the velocity at an inspection plane within the aneurysm sac decreased by up to 92.2% and 31.0% in the cases of the overlapping and single FD patterns, respectively, relative to the no-FD pattern. The simulations successfully reproduced the hemodynamics, and the qualitative and quantitative investigations are meaningful with regard to the clinical outcomes of overlapped FD deployment.
Language	English
Publishing date	2021-10-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2746191-9
ISSN	2306-5354
ISSN	2306-5354
DOI	10.3390/bioengineering8100143
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Article ; Online: Hemodynamic Characteristics and Clinical Outcome for Intracranial Aneurysms Treated with the Derivo Embolization Device, a Novel Second-Generation Flow Diverter.

Fujimura, Soichiro / Brehm, Alex / Takao, Hiroyuki / Uchiyama, Yuya / Karagiozov, Kostadin / Fukudome, Koji / Yamamoto, Makoto / Murayama, Yuichi / Psychogios, Marios-Nikos

World neurosurgery

2021 Volume 159, Page(s) e252–e259

Abstract: Background: We investigated the relationship between hemodynamic characteristics and clinical outcomes for aneurysms treated by the Derivo embolization device, a novel second-generation flow-diverter stent, using computational fluid dynamics (CFD).: ... ...

Abstract	Background: We investigated the relationship between hemodynamic characteristics and clinical outcomes for aneurysms treated by the Derivo embolization device, a novel second-generation flow-diverter stent, using computational fluid dynamics (CFD). Methods: Data were retrospectively obtained from 2 centers between 2017 and 2019. During the period, 23 patients were treated for 23 aneurysms with the Derivo embolization device. In 17 patients we were able to conduct CFD analysis as 6 were excluded due to precoiling, unsuitable arterial geometry, and complex geometric form. Aneurysm occlusion was rated with the O'Kelly-Marotta grading scale on digital subtraction angiography 6 months after stent placement in all patients. Hemodynamic and morphologic parameters were statistically compared between 2 groups: with full occlusion and with a remnant. Results: Full occlusion was observed in 17 of 23 (73.9%) patients. In the group suitable for CFD analysis, we observed 13 fully occluded aneurysms and 4 with any remnant (specifically 1 O'Kelly-Marotta C, 1 B, and 2 A). The energy loss per volume, which indicates the energy loss through the aneurysm, was significantly larger in prestenting and post stenting (P < 0.05) in the complete occlusion cases. In addition, the inflow concentration index and inflow area ratio of the remnant cases were significantly larger and lower, respectively (P < 0.05). Conclusions: Our CFD results indicate that the energy loss involved with the blood flow passing through an aneurysm and concentrated inflow into an aneurysm were the most important factors to determine whether an aneurysm will become a complete occlusion or remnant case.
MeSH term(s)	Cerebral Angiography/methods ; Embolization, Therapeutic/methods ; Endovascular Procedures/methods ; Hemodynamics ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/etiology ; Intracranial Aneurysm/therapy ; Retrospective Studies ; Stents ; Treatment Outcome
Language	English
Publishing date	2021-12-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2021.12.033
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Article ; Online: Role of patient-specific blood properties in computational fluid dynamics simulation of flow diverter deployed cerebral aneurysms.

Uchiyama, Yuya / Fujimura, Soichiro / Takao, Hiroyuki / Suzuki, Takashi / Ishibashi, Toshihiro / Otani, Katharina / Karagiozov, Kostadin / Fukudome, Koji / Yamamoto, Hideki / Yamamoto, Makoto / Murayama, Yuichi

Technology and health care : official journal of the European Society for Engineering and Medicine

2022 Volume 30, Issue 4, Page(s) 839–850

Abstract: Background: Hemodynamics and their clinical outcome of cerebral aneurysms treated with flow diverter (FD) stents have thus far been investigated using computational fluid dynamics (CFD) simulations. Although human blood is characterized as a non- ... ...

Abstract	Background: Hemodynamics and their clinical outcome of cerebral aneurysms treated with flow diverter (FD) stents have thus far been investigated using computational fluid dynamics (CFD) simulations. Although human blood is characterized as a non-Newtonian patientspecific fluid, non-patient-specific blood properties (PSBP) were applied in most extant studies. Objective: To investigate the hemodynamic effects caused by PSBPs in aneurysms treated with FD stents. Methods: We measured blood properties (density and viscosity) for 12 patients who underwent FD stent deployment. We conducted CFD simulations with the measured PSBPs and non-PSBPs quoted from previous studies. The average blood flow velocity and wall shear stress within the aneurysms were calculated and two simulation patterns were compared. Results: The velocity and wall shear stress changed by 2.93% and 3.16% on average, respectively, without an FD stent deployed. Conversely, with the FD stents deployed, the change rates increased to 11.1% and 9.06% on average, respectively. Conclusions: The change in hemodynamic parameters if PSBPs are considered, may not be negligible when conducting CFD simulations of FD stent deployed aneurysms To obtain an adequate hemodynamic environment for cerebral aneurysms with FD stents deployed, it is recommended to use PSBPs for CFD simulations.
MeSH term(s)	Computer Simulation ; Hemodynamics ; Humans ; Hydrodynamics ; Intracranial Aneurysm ; Stents
Language	English
Publishing date	2022-02-03
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1159961-3
ISSN	1878-7401 ; 0928-7329
ISSN (online)	1878-7401
ISSN	0928-7329
DOI	10.3233/THC-213216
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Article ; Online: Effects of different stent wire mesh densities on hemodynamics in aneurysms of different sizes.

Masuda, Shunsuke / Fujimura, Soichiro / Takao, Hiroyuki / Takeshita, Kohei / Suzuki, Takashi / Uchiyama, Yuya / Karagiozov, Kostadin / Ishibashi, Toshihiro / Fukudome, Koji / Yamamoto, Makoto / Murayama, Yuichi

PloS one

2022 Volume 17, Issue 6, Page(s) e0269675

Abstract: Background: Intracranial stents are used to treat aneurysms by diverting the blood flow from entering into the aneurysmal dome. Although delayed rupture is rare, clinical outcomes are extremely poor in such cases. Hemodynamics after stent deployment may ...

Abstract	Background: Intracranial stents are used to treat aneurysms by diverting the blood flow from entering into the aneurysmal dome. Although delayed rupture is rare, clinical outcomes are extremely poor in such cases. Hemodynamics after stent deployment may be related to delayed rupture and a better understanding of the basic characteristics of pressure changes resulting from stent deployment is needed; therefore, this study investigated the relationships between hemodynamics in aneurysms of different sizes treated using stents of different wire mesh densities. Methods: Using computational fluid dynamics analysis, parameters related to velocity, volume flow rate, pressure, and residual volume inside the aneurysm were evaluated in digital models of 5 basic aneurysms of differing sizes (Small, Medium, Medium-Large, Large, and Giant) and using 6 different types of stent (varying number of wires, stent pitch and wire mesh density) for each aneurysm. Results: Regardless of the aneurysm size, the velocity inside the aneurysm and the volume flow rate into the aneurysm were observed to continuously decrease up to 89.2% and 78.1%, respectively, with increasing stent mesh density. In terms of pressure, for giant aneurysms, the pressure on the aneurysmal surface elevated to 10.3%, then decreased to 5.1% with increasing stent mesh density. However, in smaller aneurysms, this pressure continuously decreased with increasing stent mesh density. The flow-diverting effect of the stents was limited when a stent with low mesh density (under 20%) was used with a giant aneurysm. Conclusions: The present results indicate that the selection of appropriate stents according to aneurysm size may contribute to reduced risks of hemodynamic alternations related to stent deployment, which could reduce the incidence of delayed rupture.
MeSH term(s)	Hemodynamics ; Humans ; Hydrodynamics ; Intracranial Aneurysm ; Stents ; Surgical Mesh
Language	English
Publishing date	2022-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0269675
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Article ; Online: Extraction of patient-specific boundary conditions from 4D-DSA and their influence on CFD simulations of cerebral aneurysms.

Uchiyama, Yuya / Fujimura, Soichiro / Takao, Hiroyuki / Ono, Hiroshi / Katayama, Keigo / Suzuki, Takashi / Ishibashi, Toshihiro / Otani, Katharina / Karagiozov, Kostadin / Fukudome, Koji / Murayama, Yuichi / Yamamoto, Makoto

Computer methods in biomechanics and biomedical engineering

2022 Volume 25, Issue 11, Page(s) 1222–1234

Abstract: We developed a new technique for extracting patient-specific inflow conditions, such as the pulse cycle duration and blood flow velocity, from four-dimensional digital subtraction angiography images and experimentally examined its validity. The maximum ... ...

Abstract	We developed a new technique for extracting patient-specific inflow conditions, such as the pulse cycle duration and blood flow velocity, from four-dimensional digital subtraction angiography images and experimentally examined its validity. The maximum error between the values extracted by the technique and measured values was 14.3%. We performed blood flow simulations and calculated representative haemodynamic parameters. The maximum differences between the parameters obtained using general and patient-specific inflow conditions were approximately 400%, 150%, and 50% for the velocity, normalised wall shear stress, and pressure loss coefficient, respectively. These results indicate that patient-specific conditions are critical for accurately reproducing aneurysmal haemodynamics.
MeSH term(s)	Angiography, Digital Subtraction/methods ; Blood Flow Velocity/physiology ; Hemodynamics/physiology ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Models, Cardiovascular ; Stress, Mechanical
Language	English
Publishing date	2022-02-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2071764-7
ISSN	1476-8259 ; 1025-5842
ISSN (online)	1476-8259
ISSN	1025-5842
DOI	10.1080/10255842.2021.2005035
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Zs.A 6374: Show issues

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Article ; Online: Computational fluid dynamic analysis of the initiation of cerebral aneurysms.

Fujimura, Soichiro / Tanaka, Kazutoshi / Takao, Hiroyuki / Okudaira, Takuma / Koseki, Hirokazu / Hasebe, Akiko / Suzuki, Takashi / Uchiyama, Yuya / Ishibashi, Toshihiro / Otani, Katharina / Karagiozov, Kostadin / Fukudome, Koji / Hayakawa, Motoharu / Yamamoto, Makoto / Murayama, Yuichi

Journal of neurosurgery

2021 , Page(s) 1–9

Abstract: Objective: Relationships between aneurysm initiation and hemodynamic factors remain unclear since de novo aneurysms are rarely observed. Most previous computational fluid dynamics (CFD) studies have used artificially reproduced vessel geometries before ... ...

Abstract	Objective: Relationships between aneurysm initiation and hemodynamic factors remain unclear since de novo aneurysms are rarely observed. Most previous computational fluid dynamics (CFD) studies have used artificially reproduced vessel geometries before aneurysm initiation for analysis. In this study, the authors investigated the hemodynamic factors related to aneurysm initiation by using angiographic images in patients with cerebral aneurysms taken before and after an aneurysm formation. Methods: The authors identified 10 cases of de novo aneurysms in patients who underwent follow-up examinations for existing cerebral aneurysms located at a different vessel. The authors then reconstructed the vessel geometry from the images that were taken before aneurysm initiation. In addition, 34 arterial locations without aneurysms were selected as control cases. Hemodynamic parameters acting on the arterial walls were calculated by CFD analysis. Results: In all de novo cases, the aneurysmal initiation area corresponded to the highest wall shear stress divergence (WSSD point), which indicated that there was a strong tensile force on the arterial wall at the initiation area. The other previously reported parameters did not show such correlations. Additionally, the pressure loss coefficient (PLc) was statistically significantly higher in the de novo cases (p < 0.01). The blood flow impact on the bifurcation apex, or the secondary flow accompanied by vortices, resulted in high tensile forces and high total pressure loss acting on the vessel wall. Conclusions: Aneurysm initiation may be more likely in an area where both tensile forces acting on the vessel wall and total pressure loss are large.
Language	English
Publishing date	2021-12-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2021.8.JNS211452
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