Numerical study of a thrombus migration risk in aneurysm after coil embolization in patient cases: FSI modelling

Abstract

Purpose There are still many challenges for modelling a thrombus migration process in aneurysms. The main novelty of the present research lies in the modelling of aneurysm clot migration process in a realistic cerebral aneurysm, and the analysis of forces sufered by clots inside an aneurysm, through transient FSI simulations. Methods The blood fow has been modelled using a Womersley velocity profle, and following the Carreau viscosity model. Hyperelastic Ogden model has been used for clot and isotropic linear elastic model for the artery walls. The FSI coupled model was implemented in ANSYS® software. The hemodynamic forces sufered by the clot have been quantifed using eight diferent clot sizes and positions inside a real aneurysm. Results The obtained results have shown that it is almost impossible for clots adjacent to aneurysm walls, to leave the aneurysm. Nevertheless, in clots positioned in the centre of the aneurysm, there is a real risk of clot migration. The risk of migration of a typical post-coiling intervention clot in an aneurysm, in contact with the wall and occupying a signifcant percentage of its volume is very low in the case studied, even in the presence of abnormally intense events, associated with sneezes or impacts. Conclusions The proposed methodology allows evaluating the clot migration risk, vital for evaluating the progress after endovascular interventions, it is a step forward in the personalized medicine, patient follow-up, and helping the medical team deciding the optimal treatment.