Systems and methods for simulation of occluded arteries and optimization of occlusion-based treatments

A computer-implemented method of planning an occlusive procedure, the method comprising:

• obtaining image data of at least a portion of a patient's vasculature;
• generating a patient-specific anatomic model of the portion of the patient's vasculature based on the image data by reconstructing at least one centerline and at least one corresponding lumen of at least one blood vessel of the patient's vasculature visible in the image data;
• determining an initial computational model of blood flow through the patient's vasculature based on the patient-specific anatomic model, the initial computational model including a pre-treatment boundary condition;
• determining a pre-treatment value for a blood flow characteristic by performing a calculation of blood flow using the initial computational model;
• determining a patient-specific target value for the blood flow characteristic;
• prior to treatment of the patient, obtaining one or more candidate sites for the occlusive procedure;
• prior to treatment of the patient, and for each respective candidate site of the one or more candidate sites, performing a candidate site evaluation that includes:
• determining a post-treatment boundary condition by modifying the patient-specific anatomic model to include one or more cross-sectional outlets, surfaces, or boundaries in modeled vasculature of the patient-specific anatomic model corresponding to an occlusion at the respective candidate site by removing a portion of the patient's vasculature from the patient-specific anatomical model that is downstream of a plane perpendicular to the at least one centerline at the respective candidate site;
• updating the initial computational model based on the post-treatment boundary condition in the modified patient-specific anatomic model;
• and
• noninvasively determining a respective post-treatment value of the blood flow characteristic value by performing a calculation of blood flow using the updated computational model;
• determining whether the respective post-treatment value of the blood flow characteristics meets or exceeds the patient-specific target value;
• in response to determining that the respective post-treatment value does not meet the patient-specific target value, iteratively identifying a new candidate site and repeating the candidate site evaluation for the new candidate site until the respective post-treatment value of the blood flow characteristics meets or exceeds the target value;
• and
• in response to determining that the respective post-treatment value of the blood flow characteristics meets or exceeds the patient-specific target value, generating a plan for the occlusive procedure that includes a recommendation for selection of a treatment site corresponding to the respective post-treatment value.

A system for planning an occlusive procedure, comprising:

• at least one memory storing instructions;
• and
• at least one processor operatively connected to the at least one memory, and configured to execute the instruction to perform operations including:
• obtaining image data of at least a portion of a patient's vasculature;
• generating a patient-specific anatomic model of the portion of the patient's vasculature based on the image data by reconstructing at least one centerline and at least one corresponding lumen of at least one blood vessel of the patient's vasculature visible in the image data;
• determining an initial computational model of blood flow through the patient's vasculature based on the patient-specific anatomic model, the initial computational model including a pre-treatment boundary condition;
• determining a pre-treatment value for a blood flow characteristic by performing a calculation of blood flow using the initial computational model;
• determining a patient-specific target value for the blood flow characteristic;
• prior to treatment of the patient, obtaining one or more candidate sites for the occlusive procedure;
• prior to treatment of the patient, and for each respective candidate site of the one or more candidate sites, performing a candidate site evaluation that includes:
• determining a post-treatment boundary condition by modifying the patient-specific anatomic model to include one or more cross-sectional outlets, surfaces, or boundaries in modeled vasculature of the patient-specific anatomic model corresponding to an occlusion at the respective candidate site by removing a portion of the patient's vasculature from the patient-specific anatomical model that is downstream of a plane perpendicular to the at least one centerline at the respective candidate site;
• updating the initial computational model based on the post-treatment boundary condition in the modified patient-specific anatomic model;
• and
• noninvasively determining a respective post-treatment value of the blood flow characteristic value by performing a calculation of blood flow using the updated computational model;
• determining whether the respective post-treatment value of the blood flow characteristics meets or exceeds the patient-specific target value;
• in response to determining that the respective post-treatment value does not meet the patient-specific target value, iteratively identifying a new candidate site and repeating the candidate site evaluation for the new candidate site until the respective post-treatment value of the blood flow characteristics meets or exceeds the target value;
• and
• in response to determining that the respective post-treatment value of the blood flow characteristics meets or exceeds the patient-specific target value, generating a plan for the occlusive procedure that includes a recommendation for selection of a treatment site corresponding to the respective post-treatment value.

A non-transitory computer-readable medium comprising instructions that are executable by a processor to perform operations including:

• obtaining image data of at least a portion of a patient's vasculature;
• generating a patient-specific anatomic model of the portion of the patient's vasculature based on the image data by reconstructing at least one centerline and at least one corresponding lumen of at least one blood vessel of the patient's vasculature visible in the image data;
• determining an initial computational model of blood flow through the patient's vasculature based on the patient-specific anatomic model, the initial computational model including a pre-treatment boundary condition;
• determining a pre-treatment value for a blood flow characteristic by performing a calculation of blood flow using the initial computational model;
• determining a patient-specific target value for the blood flow characteristic;
• prior to treatment of the patient, obtaining one or more candidate sites for the occlusive procedure;
• prior to treatment of the patient, and for each respective candidate site of the one or more candidate sites, performing a candidate site evaluation that includes:
• determining a post-treatment boundary condition by modifying the patient-specific anatomic model to include one or more cross-sectional outlets, surfaces, or boundaries in modeled vasculature of the patient-specific anatomic model corresponding to an occlusion at the respective candidate site by removing a portion of the patient's vasculature from the patient-specific anatomical model that is downstream of a plane perpendicular to the at least one centerline at the respective candidate site;
• updating the initial computational model based on the post-treatment boundary condition in the modified patient-specific anatomic model;
• and
• noninvasively determining a respective post-treatment value of the blood flow characteristic value by performing a calculation of blood flow using the updated computational model;
• determining whether the respective post-treatment value of the blood flow characteristics meets or exceeds the patient-specific target value;
• in response to determining that the respective post-treatment value does not meet the patient-specific target value, iteratively identifying a new candidate site and repeating the candidate site evaluation for the new candidate site until the respective post-treatment value of the blood flow characteristics meets or exceeds the target value;
• and
• in response to determining that the respective post-treatment value of the blood flow characteristics meets or exceeds the patient-specific target value, generating a plan for the occlusive procedure that includes a recommendation for selection of a treatment site corresponding to the respective post-treatment value.