{
  "abstract": "Introduction Background Intracranial sinus stenosis (ISS) or sinus occlusions (SO) can lead to elevated intracranial venous blood pressure. Treatment strategies are advancing, but clinical decision making and the prediction of treatment success is hampered by the variable venous anatomy.Aim of Study We aimed to create a patient-specific computational model that allows for simulating pathologies and their influence on venous flow dynamics and pressure.Method The model was created based on a neurologically healthy patient’s CT-angiography using semi-automatic threshold-based segmentation with subsequent flow modeling through computational fluid dynamics – see figure 1. Venous flow velocities were compared to a healthy cohort’s flow encoded magnetic resonance imaging (4D Flow MRI). Nine scenarios, including ISS and SO at different locations, were simulated and their influence on venous pressure and blood flow was quantified.Abstract A118 Figure 1a) Segmented geometry. Blue: superior sagittal sinus, straight sinus, transverse sinuses, sigmoid sinuses; Yellow: branches of the straight sinus; Green: cavernous sinus; Pink: anastomotic veins. b) Final geometry for the healthy case with boundary conditions. Green arrows: mass flow inlets. The numbers represent the inlets 1–4, that are also referred to in supplementary table 1. Blue arrows: pressure outlets. Orange surface: distributed mass flow inletResults In comparison to a healthy cohort’s 4D Flow MRI, the model showed comparable venous velocities at all reference points. Unilateral transverse sinus occlusion or stenosis led to compensatory contralateral flow and elevated pressures up to 12 mmHg. Extensive SO or bilateral transverse ISS led to markedly increased pressures > 100 mmHg. – simulated scenarios are presented in figure 2.Abstract A118 Figure 2Geometries of the different simulated pathologies, the boundary conditions (inlets/outlets) were similar to the visualizations in figure 1b, only for case h) no distributed mass flow inlet (orange surface in supplementary figure 1b)) was possible, a) stenosis of left sigmoid sinus, b) stenosis of right sigmoid sinus, c) stenosis of both sigmoid sinuses, d) occlusion of left sigmoid sinus, e) occlusion of right sigmoid sinus, f) occlusion of both sigmoid sinuses, g) occlusion of rectus, h) occlusion of sagittalis, i) occlusion of rectus and sagittalisConclusion The patient specific model that we present depicts realistic venous blood pressures and gradients and could support clinicians and neurointerventionists in identifying patients with intracranial sinus stenosis or sinus occlusions profiting from endovascular treatment strategies.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Universtiy Hospital RWTH Aachen, Aachen, Germany"
      ],
      "name": "Charlotte Weyland"
    },
    {
      "affiliations": [
        "Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany"
      ],
      "name": "Michael Neidlin"
    },
    {
      "affiliations": [
        "Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany"
      ],
      "name": "Cilli Danker"
    },
    {
      "affiliations": [
        "Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany"
      ],
      "name": "Linda Puppendahl"
    },
    {
      "affiliations": [
        "Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany"
      ],
      "name": "Christian Sitzer"
    },
    {
      "affiliations": [
        "Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany"
      ],
      "name": "Julian Wynhoff"
    },
    {
      "affiliations": [
        "Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany"
      ],
      "name": "Ulrich Steinseifer"
    },
    {
      "affiliations": [
        "University Hospital Aachen, Department of Neuroradiology, Germany, Germany"
      ],
      "name": "Omid Nikoubashman"
    }
  ],
  "title": "A118 Effect of stenoses and occlusions in the cerebral venous vasculature on intracranial venous hemodynamics – a patient-specific computational model",
  "uid": "efe2d21a-1716-5809-ace1-5a79c6e53cf4"
}