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Preliminary in vitro angiographic comparison of the flow diversion behavior of Evolve and Pipeline devices
  1. Chander Sadasivan,
  2. David Fiorella
  1. Department of Neurosurgery, Stony Brook University Medical Center, Stony Brook, New York, USA
  1. Correspondence to Chander Sadasivan, Department of Neurosurgery, Stony Brook University Medical Center, Stony Brook, NY 11794, USA; csadasivan{at}sbumed.org

Abstract

Background and purpose Flow diverters are increasingly used to treat a broad category of cerebral aneurysms. We conducted an in vitro study to angiographically compare the flow diversion effect of Surpass Evolve from Stryker Neurovascular with the Pipeline Shield Embolization Device from Medtronic Neurovascular.

Methods Three copies each of three carotid aneurysm geometries were manufactured from silicone. Evolve and Pipeline flow diverters were deployed in one copy of each geometry; the third copy was used as Control. High-speed angiography was acquired under pulsatile flow in each replica, contrast concentration-time curves within the aneurysms were recorded, and the curves were quantified with six parameters. The parameters were statistically evaluated to compare the flow diversion effect of both devices.

Results The Evolve showed greater flow diversion trends in almost all intra-geometry comparisons than the Pipeline. When aggregated over the three geometries, the Evolve was statistically significantly better than the Pipeline in four of the six parameters, and about the same or better (not statistically significant) than the Pipeline in the other two parameters.

Conclusions The Evolve device demonstrated greater in vitro flow diversion effects than Pipeline. Comparative efficacy of the devices will need to be adjudicated based on clinical outcomes.

  • aneurysm
  • flow diverter
  • device
  • angiography
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Footnotes

  • Contributors CS contributed to all aspects of the study. DF contributed to study conception and design, device deployments, and critical review of the manuscript.

  • Funding This project was funded by Stryker Neurovascular under SUNY RF award #82609/project #1149207.

  • Competing interests All authors have significant financial interests in Vascular Simulations, Inc. DF has received consulting, proctoring, and/or research support from both Stryker Neurovascular and Medtronic Neurovascular.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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