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New Concept of Patient-specific Flow Diversion Treatment of Intracranial Aneurysms : Design Aspects and in vitro Fluid Dynamics.
Clinical Neuroradiology ( IF 2.8 ) Pub Date : 2020-07-10 , DOI: 10.1007/s00062-020-00930-1
Andreas Ding 1, 2 , Andrés Braschkat 1 , Andreas Guber 3 , Giorgio Cattaneo 4
Affiliation  

Purpose

Current flow diverter (FD) designs limit the possibilities to achieve ideal functional parameters for intra-aneurysmal flow alteration in the implanted state. In this work, we evaluate the technical feasibility of a new patient-specific FD concept and the impact on intra-aneurysmal flow reduction compared to standard FD.

Methods

Based on a literature review, we defined functional requirements, followed by the design and manufacturing of two different prototypes, which we implanted in a patient-specific phantom model. Functional porosity distributions and contour parameters were evaluated in the implanted state and compared to standard FD. Subsequently, we carried out a series of particle image velocimetry (PIV) measurements, in order to assess the impact on intra-aneurysmal flow.

Results

With both patient-specific prototypes, it was possible to achieve stronger intra-aneurysmal flow reductions in terms of maximum and mean velocity and vorticity than a standard FD; however, one design showed a strong sensitivity against malpositioning. Overall, fluid dynamics parameters correlated with geometrical aspects such as the porosity and its grade of homogeneity. Beyond that, we found influences by the FD contour projection within the aneurysm, especially connected to the formation of in-jets.

Conclusion

Our results show that there is a technically feasible concept, which enables a more specific adjustment of functional FD parameters and more effective intra-aneurysmal flow reduction. This could potentially lead to improvements in the efficacy of aneurysm occlusion in cases with challenging fluid dynamics.



中文翻译:

颅内动脉瘤患者特异性分流治疗的新概念:设计方面和体外流体动力学。

目的

电流分流器 (FD) 设计限制了在植入状态下实现动脉瘤内流动改变的理想功能参数的可能性。在这项工作中,我们评估了新的患者特定 FD 概念的技术可行性以及与标准 FD 相比对动脉瘤内血流减少的影响。

方法

根据文献综述,我们定义了功能要求,然后设计和制造了两种不同的原型,我们将其植入患者特定的幻影模型中。在植入状态下评估功能孔隙度分布和轮廓参数,并与标准 FD 进行比较。随后,我们进行了一系列粒子图像测速 (PIV) 测量,以评估对动脉瘤内血流的影响。

结果

使用这两种特定于患者的原型,就最大和平均速度和涡度而言,与标准 FD 相比,可以实现更强的动脉瘤内流量减少;然而,一种设计对错位表现出很强的敏感性。总体而言,流体动力学参数与几何方面相关,例如孔隙率及其均匀性等级。除此之外,我们还发现了动脉瘤内 FD 轮廓投影的影响,特别是与射流的形成有关。

结论

我们的结果表明,有一个技术上可行的概念,可以更具体地调整功能性 FD 参数,并更有效地减少动脉瘤内流量。在具有挑战性的流体动力学的情况下,这可能会导致动脉瘤闭塞疗效的提高。

更新日期:2020-07-10
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