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E-070 Evaluation of flow control relative to guide catheter position during acute ischemic stroke treatment
  1. H Berns1,
  2. O Asgari1,
  3. J Wells1,
  4. O Fisher1,
  5. H Gardner1,
  6. W Merritt1,
  7. A Ducruet2,
  8. T Becker1
  1. 1Northern Arizona University, Flagstaff, AZ, USA
  2. 2Barrow Neurological Institute, Phoenix, AZ, USA


Introduction/Purpose Preliminary flow control studies conducted on the right side of an anatomically correct neurovasculature model show that aspiration and guide catheter combinations resulted in significant flow reduction in the affected right middle cerebral artery (R-MCA), with ~60% reduction when 8F guide catheters are positioned in the right internal carotid artery (R-ICA) and 6F aspiration catheters positioned in the R-MCA. The Zoom 88 device resulted in the highest flow reduction (96%) when placed in the R-MCA. The purpose of this study is to compare the effect of intracranial flow parameters for catheter placement in the left side of the anatomically correct neurovasculature model.

Materials and Methods Using the Bioengineering Devices Laboratory (BDL) benchtop flow model at Northern Arizona University (NAU), real-time flow and pressure measurements were recorded in an anatomically correct circle of Willis (CW) using various aspiration catheters accessing the L-MCA. Guide catheters used to access the L-MCA via the left internal carotid artery (L-ICA) included four scenarios: 1) Zoom 71 (Imperative Care, Z71) within Neuron MAX (Penumbra, NM), 2) Z71 within Ballast (Balt, Ball), Z71 within Walrus (Q’APel Medical, W-BGC), 3) React 68 (Medtronic, R68) within FlowGate2 (Stryker, F-BGC), and 4) Z71 within the Zoom 88 (Imperative Care, Z88) (figure 1A).

The flow model consisted of a programmable, SuperPump AR (ViVitro Labs) simulating physiological neurovascular flows and pressures with real-time pressure and flow measurements at each CoW branch. The benchtop accommodated swappable 3D-printed CoW models made from UV-cured acrylic-based co-polymers, with anatomical dimensions and mechanical properties similar to human vessels. The flow model also incorporated a shear-thinning and viscosity-matched blood analog.

Results All catheter combinations resulted in significant flow reduction in the affected middle cerebral artery (MCA) using standard 8F guide catheters in the L-ICA and 6F aspiration catheters in the L-MCA (figure 1C). However, Zoom-88 placement within the L-MCA resulted in the greatest flow reduction (real-time flow measurement verified with fluoroscopy, figure 1B).

Conclusion The benchtop flow model provided physiologically-relevant vessel tortuosity, hemodynamics, and vessel material characteristics. The resulting quantification of the intracranial flow effects in the vessel branches during aspiration catheter placement provides valuable information regarding flow through the CW in the left-sided vasculature for comparison to placement in the right-side of the brain.

Abstract E-070 Figure 1

A: Test article Zoom 71 (Z71) and Zoom 88 (Z88) in the L-MCA. B: Resulting absence of flow effects in the L-MCA. C: Resulting MCA outflows for various test articles and placements in the L-MCA

Disclosures H. Berns: None. O. Asgari: None. J. Wells: None. O. Fisher: None. H. Gardner: None. W. Merritt: 4; C; Aneuvas Technologies, Inc.. 5; C; Aneuvas Technologies, Inc. A. Ducruet: 2; C; Medtronic, Penumbra, Oculus, Stryker, Balt, Koswire. 4; C; Aneuvas Technologies, Inc.. 5; C; Barrow Neurological Institute. T. Becker: 4; C; Aneuvas Technologies, Inc.. 5; C; Aneuvas Technologies, Inc., Northern Arizona University.

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