Virtual Deployment of Braided Flow Diverters in Patient-Specific Cerebral Aneurysms

  • Frank, Martin (University of the Bundeswehr Munich)
  • Steinbrecher, Ivo (University of the Bundeswehr Munich)
  • Mayr, Matthias (University of the Bundeswehr Munich)
  • Popp, Alexander (University of the Bundeswehr Munich)

Please login to view abstract download link

A cerebral aneurysm is a bulge arising from a local weakness of an intracranial vessel wall. Rupture carries a high risk of severe disability or death. Endovascular treatment options such as Coils, Woven EndoBridge devices, and stent-like flow diverters (FDs) aim to reduce intra-aneurysmal flow and to trigger thrombus formation to achieve a permanent occlusion. To support clinical planning and treatment, numerical simulations can provide detailed insights into patient-specific anatomical and procedural settings and serve as additional decision support for neuroradiologists. This requires accurate models of endovascular devices [2], including their interaction with catheters and arterial walls, particularly in complex cases where the combined application of multiple devices may improve treatment outcomes. We present a virtual FD deployment workflow implemented in the open-source multiphysics framework 4C [1]. The initial geometry of an FD is created by a parametric description and is modeled as braided beams using geometrically exact Simo–Reissner beam finite elements [3], which interact with an arterial wall modeled as a three-dimensional nonlinear continuum. The virtual deployment is realized in three steps: crimping into a microcatheter, navigation of the catheter to the target vessel, and release of the device due to its self-expansion within the vessel. During this virtual intervention, contact at beam intersections as well as between the wires and surrounding structures is handled through dedicated beam-to-beam and mixed-dimensional coupling formulations resulting in a high-fidelity modeling approach. The proposed computational framework captures essential mechanical and geometric characteristics of braided flow diverters during deployment, as indicated by selected validation cases from the literature. The influence of device sizing and deployment forces on wall apposition, neck coverage, and overall deployment behavior is explored using a patient-specific case. [1] 4C. 4C: A Comprehensive Multiphysics Simulation Framework. https://www.4c-multiphysics.org. Accessed: 12.05.2025. 2025. [2] Martin Frank et al. “Numerical simulation of endovascular treatment options for cerebral aneurysms”. In: GAMM-Mitteilungen 47.3 (2024). [3] Christoph Meier, Alexander Popp, and Wolfgang A. Wall. “Geometrically Exact Finite Element Formulations for Slender Beams: Kirchhoff–Love Theory Versus Simo–Reissner Theory”. In: Arch. Comput. Methods Eng. 26.1 (2017).