Abstract W P76: Parent Artery Curvature May Help Determine the Effectiveness of Flow Diverter Treatment
Introduction: Flow diverters (FDs) aim to treat intracranial aneurysms by altering intra-aneurysmal hemodynamics. Reports have suggested aneurysm and parent artery shape may affect flow reduction in FD-treatment. The purpose of this study is to gain insight into the way in which aneurysm shape and parent artery curvature influence the ability of FDs to redirect flow.
Hypothesis: Aneurysm dome size and parent artery curvature affect FD-induced flow reduction within an aneurysm.
Methods: FD models constructed based on the Pipeline Embolization Device with 35% area coverage, 30 um strand diameter, and 4 mm nominal diameter were implemented for hemodynamic simulation analysis. The flow reduction effects were tested using aneurysm models featuring different dome sizes and parent artery curvatures. Aneurysm blood flow was analyzed before and after FD stenting in regions of the aneurysm neck, body, and dome.
Results: We found that aneurysms with higher parent artery curvature had increased systole flow volume entering aneurysms before and after stenting, regardless of aneurysm size, with pre-FD volume flow rates for curvatures of 20 and 30 degrees, respectively, 1.54 and 2.40 times those for 10 degree curvature. Furthermore, FD reduced flow less in aneurysms with higher curvature. For parent artery curvatures of 10, 20, and 30 degrees, overall reductions of flow volume entering the aneurysm were 91.1±0.56%, 88.2±1.2%, and 85.5±0.28%, respectively. 97.2% of models had more flow reduction at the aneurysm dome than neck. Figure 1 shows representative, post-FD flow in 10 and 30 degree parent arteries, with a greater volume flow rate in (b) depicted by denser streamlines. Aneurysm dome size was not found to have a significant effect on volume flow rate.
Conclusions: We found that artery curvature may have a large influence on FD flow reduction, indicating that FD may be less effective at reducing blood flow entering aneurysms located within higher curvature arteries.
Author Disclosures: B. Dimapasoc: None. A. Chien: None.
- © 2014 by American Heart Association, Inc.