Literature DB >> 25400707

The 'Sphere': A Dedicated Bifurcation Aneurysm Flow-Diverter Device.

Thomas Peach1, J Frederick Cornhill2, Anh Nguyen2, Howard Riina3, Yiannis Ventikos4.   

Abstract

We present flow-based results from the early stage design cycle, based on computational modeling, of a prototype flow-diverter device, known as the 'Sphere', intended to treat bifurcation aneurysms of the cerebral vasculature. The device is available in a range of diameters and geometries and is constructed from a single loop of NITINOL® wire. The 'Sphere' reduces aneurysm inflow by means of a high-density, patterned, elliptical surface that partially occludes the aneurysm neck. The device is secured in the healthy parent vessel by two armatures in the shape of open loops, resulting in negligible disruption of parent or daughter vessel flow. The device is virtually deployed in six anatomically accurate bifurcation aneurysms: three located at the Basilar tip and three located at the terminus bifurcation of the Internal Carotid artery (at the meeting of the middle cerebral and anterior cerebral arteries). Both steady state and transient flow simulations reveal that the device presents with a range of aneurysm inflow reductions, with mean flow reductions falling in the range of 30.6-71.8% across the different geometries. A significant difference is noted between steady state and transient simulations in one geometry, where a zone of flow recirculation is not captured in the steady state simulation. Across all six aneurysms, the device reduces the WSS magnitude within the aneurysm sac, resulting in a hemodynamic environment closer to that of a healthy vessel. We conclude from extensive CFD analysis that the 'Sphere' device offers very significant levels of flow reduction in a number of anatomically accurate aneurysm sizes and locations, with many advantages compared to current clinical cylindrical flow-diverter designs. Analysis of the device's mechanical properties and deployability will follow in future publications.

Entities:  

Keywords:  CFD; Medical devices; Minimally invasive; Neurovascular; PED; SILK; Shear stress; Stent; Thrombosis; WEB; WSS

Year:  2014        PMID: 25400707      PMCID: PMC4226933          DOI: 10.1007/s13239-014-0188-4

Source DB:  PubMed          Journal:  Cardiovasc Eng Technol        ISSN: 1869-408X            Impact factor:   2.495


  44 in total

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Authors:  J F HALE; D A McDONALD; J R WOMERSLEY
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2.  Womersley number-based estimates of blood flow rate in Doppler analysis: in vivo validation by means of phase-contrast MRI.

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Journal:  IEEE Trans Biomed Eng       Date:  2010-07       Impact factor: 4.538

3.  Aneurysm rupture following treatment with flow-diverting stents: computational hemodynamics analysis of treatment.

Authors:  J R Cebral; F Mut; M Raschi; E Scrivano; R Ceratto; P Lylyk; C M Putman
Journal:  AJNR Am J Neuroradiol       Date:  2010-11-11       Impact factor: 3.825

4.  Hemodynamic shear stress and its role in atherosclerosis.

Authors:  A M Malek; S L Alper; S Izumo
Journal:  JAMA       Date:  1999-12-01       Impact factor: 56.272

Review 5.  Flow diverter stents in the treatment of intracranial aneurysms: Where are we?

Authors:  Laurent Pierot
Journal:  J Neuroradiol       Date:  2011-01-22       Impact factor: 3.447

Review 6.  Flow diversion for intracranial aneurysms: a review.

Authors:  Pietro I D'Urso; Giuseppe Lanzino; Harry J Cloft; David F Kallmes
Journal:  Stroke       Date:  2011-07-07       Impact factor: 7.914

Review 7.  Modulation of blood flow and tissue perfusion by endothelium-derived relaxing factor.

Authors:  T M Griffith
Journal:  Exp Physiol       Date:  1994-11       Impact factor: 2.969

8.  High-profile flow diverter (silk) implantation in the basilar artery: efficacy in the treatment of aneurysms and the role of the perforators.

Authors:  Zsolt Kulcsár; Ulrike Ernemann; Stephan G Wetzel; Alexander Bock; Sophia Goericke; Vasilis Panagiotopoulos; Michael Forsting; Daniel A Ruefenacht; Isabel Wanke
Journal:  Stroke       Date:  2010-07-08       Impact factor: 7.914

9.  Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association.

Authors:  E Sander Connolly; Alejandro A Rabinstein; J Ricardo Carhuapoma; Colin P Derdeyn; Jacques Dion; Randall T Higashida; Brian L Hoh; Catherine J Kirkness; Andrew M Naidech; Christopher S Ogilvy; Aman B Patel; B Gregory Thompson; Paul Vespa
Journal:  Stroke       Date:  2012-05-03       Impact factor: 7.914

10.  Endovascular WEB flow disruption in middle cerebral artery aneurysms: preliminary feasibility, clinical, and anatomical results in a multicenter study.

Authors:  Laurent Pierot; Joachim Klisch; Christophe Cognard; Istvan Szikora; Benjamin Mine; Krzysztof Kadziolka; Vojtech Sychra; Istvan Gubucz; Anne-Christine Januel; Boris Lubicz
Journal:  Neurosurgery       Date:  2013-07       Impact factor: 4.654

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  6 in total

Review 1.  The Past, Present and Future of Endovascular Aneurysm Treatment.

Authors:  H Henkes; W Weber
Journal:  Clin Neuroradiol       Date:  2015-06-02       Impact factor: 3.649

Review 2.  On Flow Diversion: The Changing Landscape of Intracerebral Aneurysm Management.

Authors:  A A Dmytriw; K Phan; J M Moore; V M Pereira; T Krings; A J Thomas
Journal:  AJNR Am J Neuroradiol       Date:  2019-03-20       Impact factor: 3.825

Review 3.  Thrombosis in Cerebral Aneurysms and the Computational Modeling Thereof: A Review.

Authors:  Malebogo N Ngoepe; Alejandro F Frangi; James V Byrne; Yiannis Ventikos
Journal:  Front Physiol       Date:  2018-04-04       Impact factor: 4.566

4.  A Virtual Comparison of the eCLIPs Device and Conventional Flow-Diverters as Treatment for Cerebral Bifurcation Aneurysms.

Authors:  T W Peach; D Ricci; Y Ventikos
Journal:  Cardiovasc Eng Technol       Date:  2019-07-08       Impact factor: 2.495

5.  Towards Predicting Patient-Specific Flow-Diverter Treatment Outcomes for Bifurcation Aneurysms: From Implantation Rehearsal to Virtual Angiograms.

Authors:  T W Peach; K Spranger; Y Ventikos
Journal:  Ann Biomed Eng       Date:  2015-08-04       Impact factor: 3.934

6.  Surgical flow modification of the anterior cerebral artery-anterior communicating artery complex in the management of giant aneurysms of internal carotid artery bifurcation: An alternative for a difficult clip reconstruction.

Authors:  Felix Hendrik Pahl; Matheus Fernandes de Oliveira; André Luiz Beer-Furlan; José Marcus Rotta
Journal:  Surg Neurol Int       Date:  2016-06-03
  6 in total

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