{"id":{"repo_id":"buffalo","oai_identifier":"oai:ubir.buffalo.edu:10477/80914"},"canonical_url":"https://search.dev.ndltd.org/etd/buffalo/oai:ubir.buffalo.edu:10477/80914","repository":{"repo_id":"buffalo","name":"Buffalo","base_url":"https://ubir.buffalo.edu/oai/request"},"display":{"title":"Predicting Long-Term Outcome of Intracranial Aneurysms Treated with Flow Diverters Using CFD and Machine Learning","abstract":"Ph.D.","abstract_html":"Ph.D.","abstract_has_math":false,"creators":["Paliwal, Nikhil; 0000-0002-0396-4409"],"institution":"State University of New York at Buffalo","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Meng, Hui","Mechanical and Aerospace Engineering"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2019,"date_issued":"2019-10-29T16:48:06Z","date_published":"2019-10-29T16:48:06Z","updated_at":"2026-07-27T19:05:25Z","subjects":["mechanical engineering","biomedical engineering","neurosciences"],"languages":["eng"],"rights":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/10477/80914","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Meng, Hui","Mechanical and Aerospace Engineering"]},{"key":"dc:creator","label":"Author","values":["Paliwal, Nikhil; 0000-0002-0396-4409"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2019-10-29T16:48:06Z","2019","2019-08-08 12:52:51"]},{"key":"dc:publisher","label":"Institution","values":["State University of New York at Buffalo"]},{"key":"dc:type","label":"Dc Type","values":["Text","Dissertation"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["mechanical engineering","biomedical engineering","neurosciences"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["eng"]},{"key":"dc:rights","label":"Dc Rights","values":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://hdl.handle.net/10477/80914"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Ph.D.","An intracranial aneurysm (IA) is a weakened bulging area in the arteries in the circle of Willis, caused due to their destructive remodeling of the blood vessel. About 1 in 50 Americans harbors an IA, but most aneurysms are largely asymptomatic. Rupture of an IA is a devastating event, which leads to subarachnoid hemorrhage that carries high morbidity and mortality rates. To avoid rupture of an aneurysm, two treatment strategies are available: surgical clipping and endovascular intervention. In surgical treatment, the site of the aneurysm is accessed through the skull of the patient, and a clip is placed around the neck of the aneurysm to remove it from the arterial circulation. Although it instantaneously excludes the IA, skull-based surgery is highly invasive, leading to high risks of complications. Alternatively, endovascular therapies have emerged in the last 3 decades that aim to exclude the IA from circulation by enabling thrombotic occlusion. Traditionally, endovascular coils, made of platinum wires, were deployed inside the IA to enable clot formation and thrombosis of the IA sac. However, coil embolization has a high recanalization rate, and is not suitable for some challenging aneurysms like wide necked aneurysms, giant aneurysms or fusiform type aneurysms.To treat traditionally challenging aneurysms, a new paradigm called flow diversion using highly dense metallic-stents called flow diverters (FDs) was approved by the FDA in 2011. Since its approval, FDs have become a mainstay of endovascular intervention of not only the traditionally challenging ones, but IAs of all types. Composed of 48 braided wires primarily made of cobalt-chromium-nickel alloy and platinum markers, FDs are deployed across the parent artery to enable flow stasis inside the IA sac, thus leading to thrombosis and eventual occlusion of the IA. However, despite recent success, clinical reports suggest that FDs fail to heal ~25% of aneurysms after 6 months of treatment. These unsuccessfully FD-treated aneurysms expose the patients at persistent risks of aneurysm rupture and other thromboembolic complications. Therefore, it is important to identify aneurysms that might not heal after FD-treatment to minimize complications and improve treatment outcomes. Since FD’s primary mechanism of healing is by diverting the blood flow away from the aneurysm, I hypothesized that the hemodynamic modifications induced by FDs in successfully treated IAs differ from those of the unsuccessful ones. Additionally, I asked if outcomes of FD-treatment could be made based on these differences in hemodynamics, along with aneurysm geometry and FD characteristics in patient-specific aneurysms. To that end, in this dissertation, I developed and applied a virtual intervention workflow for FD-treatment in patient-specific IA models."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Predicting Long-Term Outcome of Intracranial Aneurysms Treated with Flow Diverters Using CFD and Machine Learning"]}]}],"canonical_facts":{"dc:contributor":["Meng, Hui","Mechanical and Aerospace Engineering"],"dc:creator":["Paliwal, Nikhil; 0000-0002-0396-4409"],"dc:date":["2019-10-29T16:48:06Z","2019","2019-08-08 12:52:51"],"dc:description":["Ph.D.","An intracranial aneurysm (IA) is a weakened bulging area in the arteries in the circle of Willis, caused due to their destructive remodeling of the blood vessel. About 1 in 50 Americans harbors an IA, but most aneurysms are largely asymptomatic. Rupture of an IA is a devastating event, which leads to subarachnoid hemorrhage that carries high morbidity and mortality rates. To avoid rupture of an aneurysm, two treatment strategies are available: surgical clipping and endovascular intervention. In surgical treatment, the site of the aneurysm is accessed through the skull of the patient, and a clip is placed around the neck of the aneurysm to remove it from the arterial circulation. Although it instantaneously excludes the IA, skull-based surgery is highly invasive, leading to high risks of complications. Alternatively, endovascular therapies have emerged in the last 3 decades that aim to exclude the IA from circulation by enabling thrombotic occlusion. Traditionally, endovascular coils, made of platinum wires, were deployed inside the IA to enable clot formation and thrombosis of the IA sac. However, coil embolization has a high recanalization rate, and is not suitable for some challenging aneurysms like wide necked aneurysms, giant aneurysms or fusiform type aneurysms.To treat traditionally challenging aneurysms, a new paradigm called flow diversion using highly dense metallic-stents called flow diverters (FDs) was approved by the FDA in 2011. Since its approval, FDs have become a mainstay of endovascular intervention of not only the traditionally challenging ones, but IAs of all types. Composed of 48 braided wires primarily made of cobalt-chromium-nickel alloy and platinum markers, FDs are deployed across the parent artery to enable flow stasis inside the IA sac, thus leading to thrombosis and eventual occlusion of the IA. However, despite recent success, clinical reports suggest that FDs fail to heal ~25% of aneurysms after 6 months of treatment. These unsuccessfully FD-treated aneurysms expose the patients at persistent risks of aneurysm rupture and other thromboembolic complications. Therefore, it is important to identify aneurysms that might not heal after FD-treatment to minimize complications and improve treatment outcomes. Since FD’s primary mechanism of healing is by diverting the blood flow away from the aneurysm, I hypothesized that the hemodynamic modifications induced by FDs in successfully treated IAs differ from those of the unsuccessful ones. Additionally, I asked if outcomes of FD-treatment could be made based on these differences in hemodynamics, along with aneurysm geometry and FD characteristics in patient-specific aneurysms. To that end, in this dissertation, I developed and applied a virtual intervention workflow for FD-treatment in patient-specific IA models."],"dc:format":["application/pdf"],"dc:identifier":["http://hdl.handle.net/10477/80914"],"dc:language":["eng"],"dc:publisher":["State University of New York at Buffalo"],"dc:rights":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."],"dc:subject":["mechanical engineering","biomedical engineering","neurosciences"],"dc:title":["Predicting Long-Term Outcome of Intracranial Aneurysms Treated with Flow Diverters Using CFD and Machine Learning"],"dc:type":["Text","Dissertation"]},"updated_at":"2026-07-27T19:05:25Z"}