In vitro and in silico study of intracranial stent treatments for cerebral aneurysms: effects on perforating vessel flows
- Breigh Nonte Roszelle1,
- M Haithem Babiker1,
- Walter Hafner1,
- L Fernando Gonzalez2,
- Felipe C Albuquerque3,
- David H Frakes1,4
- 1School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
- 2Department of Neurological Surgery, Jefferson Medical College, Philadelphia, Pennsylvania, USA
- 3Division of Neurological Surgery, St Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, Arizona, USA
- 4School of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, Arizona, USA
- Correspondence to Dr Breigh N Roszelle, School of Biological and Health Systems Engineering, Arizona State University, P.O. Box 879709, Tempe, AZ 85287–9709, USA;
- Received 28 February 2012
- Revised 22 May 2012
- Accepted 24 May 2012
- Published Online First 26 June 2012
Background Many cerebral aneurysms can be treated effectively with intracranial stents. Unfortunately, stents can occlude perforating vessels near the treatment site which can decrease cerebral perfusion and increase the risk of stroke.
Methods Particle image velocimetry was used to investigate the effects of intracranial stents on flows in perforators near a treated aneurysm. In Phase 1 of the study, different stent configurations were deployed into an idealized physical model of a sidewall aneurysm with perforating vessels. The configurations investigated were the Pipeline embolization device (PED) and one, two and three telescoping Neuroform stents. In Phase 2 of the study a single Neuroform stent was deployed so that the stent struts directly occluded the perforating vessel.
Results In Phase 1 of the study it was found that even three telescoping stents affected perforating vessel flow less than a single PED under pulsatile conditions (average reduction 32.7% vs 46.5%). Results from Phase 2 indicated that the location of the occluding strut across the perforating vessel orifice had a greater impact on perforating vessel flow than the percentage occlusion.
Conclusion The findings of this study show that the use, configuration and positioning of intracranial stents can all have considerable influence on flow in affected perforating vessels near treated cerebral aneurysms.