Article Text
Abstract
Introduction Computed fluid dynamic studies aim to identify hemodynamic factors related to brain aneurysms to evaluate the potential risk of rupture or the flow reduction after the placement of a flow diverter stent.
At present, numerical simulations are based on virtual deployment of the stent. However, these latter follow specific biomechanical rules and are different from real deployment, which is related to operator’s maneuvers.
Aim of Study We aimed to evaluate a novel method in which computed fluid dynamic was based on real flow diverter deployment using micro-CT reconstruction after device implantation using a vascular phantom reproducing a carotid artery harbouring an aneurysm.
Methods We assessed the flow diversion effect of braided stents (16 to 64 wires) to evaluate the performance of the method. We compared the velocity reduction obtained with a stent made of 48 wires to evaluate its sensibility in identifying deployment variations due to different operator maneuvers. Moreover, the method was compared to a standard virtual deployment.
Results Simulation showed a reduction in flow within the aneurysm ranging from 14% to 40% depending on the number of stent wires. The method was able in detecting a variation of the velocity inside the aneurysm due to different operator maneuvers of ±4%. Compared to the virtual deployment, the velocity variations are up to 10%.
Conclusion We developed a method that applies to a real deployment of high wire density stent and shows high sensitivity. These findings could be applied to real cases and used to develop new neurovascular devices.
Disclosure of Interest Paolo Machi, Congress President, Consultant for Medtronic, Stryker and Microvention