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In vitro, contrast agent-based evaluation of the influence of flow diverter size and position on intra-aneurysmal flow dynamics using syngo iFlow

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

Treatment of intracranial aneurysm with flow-diverting devices has become widespread in recent years. Despite that, intra-aneurysmal flow changes are yet not fully understood and can lead to different complications. Our aim was an in vitro contrast-based evaluation of the influence of flow diverter size and position on intra-aneurysmal flow dynamics.

Methods

Flow-diverting devices with different sizes (diameters 4.0, 4.5, and 6.0 mm) were deployed in seven silicone aneurysm models at different positions relative to the aneurysm neck (proximal, central, distal). Using syngo iFlow, we defined quantitative evaluation criteria based on contrast medium intensity and performed a flow evaluation.

Results

Intra-aneurysmal flows were heavily dependent on both size and position of flow-diverting devices at the aneurysm neck. We observed a higher peak intensity delay and intra-aneurysmal washout delay with the centrally placed 4.0- and 4.5-mm device, respectively, compared to the proximal and distal positions. Especially distally placed 4.0-mm devices led to an earlier filling of the aneurysm and increased intra-aneurysmal contrast agent intensity compared to the parent vessel, due to a potential endoleak.

Conclusions

Not only size but also position of flow-diverting devices have a considerable impact on the intra-aneurysmal flow dynamics. The suggested evaluation criteria allowed a quantitative comparison of flow-diverting effect using syngo iFlow and could represent an efficient tool for predicting flow diversion pre-procedurally.

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Abbreviations

FD:

Flow-diverting device

DSA:

Digital subtraction angiography

TTP:

Time to peak

PI:

Peak intensity

PI-D:

Peak intensity delay

PI-R:

Peak intensity ratio

ID:

Intensity decrease

ID-R:

Intensity decrease ratio

IA:

Intra-aneurysmal

REF:

Reference

OL:

Overlapping

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Authors and Affiliations

  1. Acandis GmbH, Theodor-Fahrner-Str. 6, 75177, Pforzheim, Germany

    Giorgio Franco Maria Cattaneo, Andreas Ding & Tobias Jost

  2. Departments of Neuroradiology, Saarland University Hospital, Homburg, Saar, Germany

    Désirée Ley, Ruben Mühl-Bennighaus, Umut Yilmaz, Heiko Körner, Wolfgang Reith & Andreas Simgen

Authors
  1. Giorgio Franco Maria Cattaneo
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  2. Andreas Ding
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Correspondence to Giorgio Franco Maria Cattaneo.

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Funding

This study was funded in part by a research grant from the BMWi (German Ministry of Economic Affairs and Energy, Grant number: KF2335801WL9).

Conflict of interest

GFMC, AD and TJ are engineers at Acandis GmbH, Pforzheim, Germany and served as proctors during this study.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Cattaneo, G.F.M., Ding, A., Jost, T. et al. In vitro, contrast agent-based evaluation of the influence of flow diverter size and position on intra-aneurysmal flow dynamics using syngo iFlow. Neuroradiology 59, 1275–1283 (2017). https://doi.org/10.1007/s00234-017-1903-2

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  • DOI: https://doi.org/10.1007/s00234-017-1903-2

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