Hemodynamic-Structural Multi-Fidelity Assessment of Endovascular Flow Diversion Strategies for Cerebral Aneurysm Treatment: An Integrated Computational and Experimental Framework

Q: What is the clinical evidence from this study?

Population: Cerebral aneurysm (internal carotid artery aneurysm) (n=1). Intervention: Endovascular flow-diverting stent (50%, 55%, and 60% porosity in 316L stainless steel, poly-L-lactic acid, and nitinol) vs. Endovascular coils, Woven Endo-Bridge (WEB) device, and untreated baseline aneurysm model. Primary outcome: Intra-aneurysmal hemodynamic parameters (peak velocity, pressure, wall shear stress, TAWSS, OSI, RRT, vorticity) and structural stiffness equivalence.

Q: What does this research mean for the field?

Stent-assisted flow diversion yields the most favorable hemodynamic profile for cerebral aneurysm treatment compared to coils and the Woven Endo-Bridge, achieving the greatest reductions in intra-sac velocity, pressure, and time-averaged wall shear stress. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Dipu Roy; Farah Sadia Antara; Shama Abdullah Moshrur; Maruf Hasan; Kaiissar Mannoor; Muhammad Shattique; Jafrin Sultana

doi:10.64898/2026.10.13.758431

October 19, 2026Open Access

Hemodynamic-Structural Multi-Fidelity Assessment of Endovascular Flow Diversion Strategies for Cerebral Aneurysm Treatment: An Integrated Computational and Experimental Framework

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Key result

Stent-assisted flow diversion yields superior aneurysm hemodynamics, matching native-scale stiffness within ~2%.

n=1

Why the study?

Subarachnoid hemorrhage after cerebral aneurysm rupture has a 50% first-month fatality rate and endovascular flow diversion is the primary treatment modality. However, no prior study had hemodynamically compared stents, coils, and the Woven Endo-Bridge while integrating hemodynamic results with structural device behavior in one framework.

Do endovascular flow-diverting stents improve hemodynamic metrics and structural performance compared to coils, the Woven Endo-Bridge (WEB), and untreated baseline in a computational and experimental cerebral aneurysm model?

Key Points

To compare hemodynamic outcomes and structural device mechanics among flow-diverting stents, coils, and the Woven Endo-Bridge using an integrated computational and experimental framework.
Reconstructed a patient-specific cerebral aneurysm geometry from computed tomography imaging to perform computational fluid dynamics evaluating untreated, stent, coil, and WEB configurations.
Conducted finite element analysis on stents across three porosities (50%, 55%, and 60%) using 316L stainless steel, nitinol, and poly-L-lactic acid.
Validated structural simulations with universal testing machine experiments on 3D-printed polylactic acid and thermoplastic polyurethane analogues.
The untreated model displayed high-risk baseline hemodynamics, including a TAWSS of 6.68 Pa, an RRT of 2.63 Pa⁻¹, an OSI of 0.180, and a stable total pressure of 12061.9 Pa across peak systole and end diastole.
Stent diversion demonstrated the most favorable hemodynamic profile, delivering the lowest peak intra-sac velocity, greatest pressure reduction, near-zero wall shear stress, and the only reduction in cycle-averaged TAWSS.
Finite element analysis confirmed a stiffness hierarchy of Steel > Nitinol > PLLA, with 50%-porosity nitinol best matching target elastic mechanics and scaled specimens matching native stiffness within 2.3%.

Structured PICO

Do endovascular flow-diverting stents improve hemodynamic metrics and structural performance compared to coils, the Woven Endo-Bridge (WEB), and untreated baseline in a computational and experimental cerebral aneurysm model?

P

Population

Computational fluid dynamics and finite element analysis study based on CT imaging from 1 patient (age 67) with an internal carotid artery aneurysm in Bangladesh, combined with an idealized aneurysm model and experimental 3D-printed analogues.

I

Intervention

Endovascular flow-diversion strategies modeled in computational fluid dynamics (stent, coil, and Woven Endo-Bridge [WEB]) and structural finite element analysis of custom stent geometries with 50%, 55%, and 60% porosity across three materials (316L stainless steel, poly-L-lactic acid [PLLA], and nitinol)

C

Comparator

Untreated baseline aneurysm model and inter-device comparisons across stent, coil, and Woven Endo-Bridge (WEB) configurations

O

Outcome

Hemodynamic metrics (peak intra-sac velocity, total pressure, wall shear stress [WSS], time-averaged wall shear stress [TAWSS], oscillatory shear index [OSI], relative residence time [RRT], and vorticity) and structural mechanics (stiffness, elastic recovery, radial compression resistance, and radial distension)surrogate

In an integrated computational and experimental framework of cerebral aneurysm treatment, stent-assisted flow diversion demonstrated the most favorable hemodynamic reduction in intra-sac velocity, pressure, and wall shear stress compared to coiling and the Woven Endo-Bridge, with 50%-porosity nitinol best matching target elastic mechanics.

Limitations

Device comparisons were performed in an idealized aneurysm geometry rather than the patient-specific geometry to isolate device-intrinsic mechanics
Minor arterial branches were excluded and surface smoothing was applied during patient-specific geometry reconstruction
Hemodynamic simulations relied on a rigid-wall computational fluid dynamics assumption rather than fluid-structure interaction
Rigid-wall CFD assumption was used instead of compliant-wall fluid-structure interaction (FSI) models
Idealized geometry was used for the four-way device comparison rather than the patient-specific geometry
Minor arterial branches were excluded and surface smoothing was applied during geometry reconstruction

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Implication

Stent-assisted flow diversion may improve hemodynamic profiles in computational aneurysm models; leaves open clinical validation of optimized nitinol stents.

Abstract

Subarachnoid hemorrhage after cerebral aneurysm rupture has a 50% first-month fatality rate. Endovascular flow diversion is the primary treatment modality. However, no prior study has compared stents, coils, and the Woven Endo-Bridge hemodynamically integrating hemodynamic results with structural device behavior in one framework. An aneurysm model was reconstructed from computed tomography imaging of a patient, and computational fluid dynamics evaluated multiple hemodynamic metrics across three flow-diversion strategies. Finite element analysis assessed stent geometries with 50%, 55%, and 60% porosity in 316L stainless steel, poly-L-lactic acid, and nitinol. Universal testing machine tests validated the models with printed polylactic acid and thermoplastic polyurethane analogues. Dimensional and elastic-tube analyses tested scale equivalence between the FEA and UTM geometries and the rigid-wall CFD assumption. Patient-specific CFD confirmed a high-risk hemodynamic profile. The stent yielded the lowest peak intra-sac velocity, greatest pressure reduction, near-zero wall shear stress, the only reduction in time-averaged wall shear stress, cycle-averaged TAWSS, and the largest peak-systolic reductions in velocity, WSS, and vorticity. OSI and RRT rose for all three treated configurations, consistent with the hemodynamic signature of flow diversion. FEA reproduced the expected stiffness hierarchy (Steel > Nitinol > PLLA), and TPU was the closest surrogate for Nitinol’s elastic recovery. Scaled specimens matched native-scale stiffness within 2.3%. Predicted radial distension was orders of magnitude below native wall values, supporting rigid-wall CFD. Stent-assisted diversion demonstrated the most favorable hemodynamic profile. A 50%-porosity Nitinol stent best matched target elastic mechanics, while 316L stainless steel provided the greatest resistance to radial compression.

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Cite This Study

Roy et al. (2026) studied Cerebral aneurysm (internal carotid artery aneurysm) (n=1). Endovascular flow-diverting stent (50%, 55%, and 60% porosity in 316L stainless steel, poly-L-lactic acid, and nitinol) vs. Endovascular coils, Woven Endo-Bridge (WEB) device, and untreated baseline aneurysm model was evaluated on Intra-aneurysmal hemodynamic parameters (peak velocity, pressure, wall shear stress, TAWSS, OSI, RRT, vorticity) and structural stiffness equivalence. Stent-assisted flow diversion yielded the most favorable hemodynamic profile—including the only reduction in TAWSS—while scaled mechanical specimens matched native-scale stiffness within 2.3%.

synapsesocial.com/papers/6af10ed2a61b6e74a6de157e https://doi.org/10.64898/2026.10.13.758431

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Hemodynamic-Structural Multi-Fidelity Assessment of Endovascular Flow Diversion Strategies for Cerebral Aneurysm Treatment: An Integrated Computational and Experimental Framework

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Hemodynamic-Structural Multi-Fidelity Assessment of Endovascular Flow Diversion Strategies for Cerebral Aneurysm Treatment: An Integrated Computational and Experimental Framework

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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