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New Concept of Patient-specific Flow Diversion Treatment of Intracranial Aneurysms

Design Aspects and in vitro Fluid Dynamics

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Abstract

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.

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Abbreviations

CFD:

Computational fluid dynamics

FD:

Flow diverter

IFD:

Individualized flow diverter

PIV:

Particle imaging velocimetry

WSS:

Wall shear stress

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Acknowledgements

We thank our colleagues from the ac.biomed GmbH, Aachen, Germany, who carried out the experiments and provided insight and expertise that greatly assisted the research, although they may not agree with all of the interpretations/conclusions of this paper.

Funding

This work was supported by the German Federal Ministry of Education and Research; grant number FKZ (13GW0274A-D).

Author information

Authors and Affiliations

  1. Acandis GmbH, R&D, Pforzheim, Baden-Württemberg, Germany

    Andreas Ding & Andrés Braschkat

  2. Weltzienstr. 24, 76135, Karlsruhe, Germany

    Andreas Ding

  3. Institute of Microstructure Technology, Karlsruhe Institute of Technology, Karlsruhe, Baden-Württemberg, Germany

    Andreas Guber

  4. Institute of Biomedical Engineering, University of Stuttgart, Stuttgart, Baden-Württemberg, Germany

    Giorgio Cattaneo

Authors
  1. Andreas Ding
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  2. Andrés Braschkat
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  4. Giorgio Cattaneo
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Contributions

A. Ding: conception and main execution of the work and drafting the manuscript. A. Braschkat: substantial contribution to the acquisition and analysis of the work and revising the manuscript. A. Guber: substantial contributions to the interpretation of the work and revising it critically for important intellectual content. G. Cattaneo: substantial contributions to the design of the work and interpretation of results. Critical revision of the work for important intellectual content.

Corresponding author

Correspondence to Andreas Ding.

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Conflict of interest

A. Ding and A. Braschkat are employees of the Acandis GmbH, which financed the remaining costs, not covered by the public funding. A. Ding reports grants from the German Federal Ministry of Education and Research, during the conduct of the study. In addition, A. Ding has a patent system and procedure for braiding patient-specific stents (“Verfahren zum Flechten eines patientenspezifisch angepassten Stents”) pending to Acandis GmbH. A. Guber and G. Cattaneo declare that they have no competing interests.

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Ding, A., Braschkat, A., Guber, A. et al. New Concept of Patient-specific Flow Diversion Treatment of Intracranial Aneurysms. Clin Neuroradiol 31, 671–679 (2021). https://doi.org/10.1007/s00062-020-00930-1

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  • DOI: https://doi.org/10.1007/s00062-020-00930-1

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