Simon Tupin1, Kei Takase2, Makoto Ohta3. 1. Biomedical Flow Dynamics Laboratory, Institute of Fluid Science, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi, 980-8577, Japan. s.tupin@tohoku.ac.jp. 2. Department of Diagnostic Radiology, Tohoku University School of Medicine, Sendai, Miyagi, Japan. 3. Biomedical Flow Dynamics Laboratory, Institute of Fluid Science, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi, 980-8577, Japan.
Abstract
PURPOSE: The multilayer flow modulator (MFM) device has been used for the treatment of abdominal aortic aneurysm (AAA) for over a decade. Although several clinical studies have been published, criticism and concern over the device efficacy remain, as no quantitative analysis that describes its mechanism has been performed yet. The aim of this study was to experimentally evaluate the effect of MFM device deployment on aneurysmal pressure and branch perfusion. MATERIALS AND METHODS: An experimental flow and pressure monitoring system was developed to analyze the MFM deployment procedure performed by a qualified radiologist in AAA geometries with and without side branch. Particle image velocimetry experiments were then conducted on models with and without MFM device to evaluate and compare flow patterns and local flow velocity and vorticity in the aneurysm. RESULTS: The experiments revealed no significant change in pressure and flow rate during and after deployment of the MFM device. The flow rate of the incorporated branch was fully preserved. On both models, the aneurysmal flow velocity was significantly reduced. In addition, the device modified local flow patterns, reducing vorticity and better feeding the incorporated branch. CONCLUSION: This experimental study provides the basis for a better understanding of the mechanism of the MFM device, which allows intra-aneurysmal flow to decrease while preserving incorporated branch flow and reducing the risk of type II endoleak. The experimental system developed for this study was effective in simulating an endovascular procedure and studying the safety and effectiveness of endovascular devices.
PURPOSE: The multilayer flow modulator (MFM) device has been used for the treatment of abdominal aortic aneurysm (AAA) for over a decade. Although several clinical studies have been published, criticism and concern over the device efficacy remain, as no quantitative analysis that describes its mechanism has been performed yet. The aim of this study was to experimentally evaluate the effect of MFM device deployment on aneurysmal pressure and branch perfusion. MATERIALS AND METHODS: An experimental flow and pressure monitoring system was developed to analyze the MFM deployment procedure performed by a qualified radiologist in AAA geometries with and without side branch. Particle image velocimetry experiments were then conducted on models with and without MFM device to evaluate and compare flow patterns and local flow velocity and vorticity in the aneurysm. RESULTS: The experiments revealed no significant change in pressure and flow rate during and after deployment of the MFM device. The flow rate of the incorporated branch was fully preserved. On both models, the aneurysmal flow velocity was significantly reduced. In addition, the device modified local flow patterns, reducing vorticity and better feeding the incorporated branch. CONCLUSION: This experimental study provides the basis for a better understanding of the mechanism of the MFM device, which allows intra-aneurysmal flow to decrease while preserving incorporated branch flow and reducing the risk of type II endoleak. The experimental system developed for this study was effective in simulating an endovascular procedure and studying the safety and effectiveness of endovascular devices.
Authors: Anders Wanhainen; Fabio Verzini; Isabelle Van Herzeele; Eric Allaire; Matthew Bown; Tina Cohnert; Florian Dick; Joost van Herwaarden; Christos Karkos; Mark Koelemay; Tilo Kölbel; Ian Loftus; Kevin Mani; Germano Melissano; Janet Powell; Zoltán Szeberin; Gert J de Borst; Nabil Chakfe; Sebastian Debus; Rob Hinchliffe; Stavros Kakkos; Igor Koncar; Philippe Kolh; Jes S Lindholt; Melina de Vega; Frank Vermassen; Martin Björck; Stephen Cheng; Ronald Dalman; Lazar Davidovic; Konstantinos Donas; Jonothan Earnshaw; Hans-Henning Eckstein; Jonathan Golledge; Stephan Haulon; Tara Mastracci; Ross Naylor; Jean-Baptiste Ricco; Hence Verhagen Journal: Eur J Vasc Endovasc Surg Date: 2018-12-05 Impact factor: 7.069
Authors: Timothy Éanna Murray; Paul Brennan; Julian T Maingard; Ronil V Chandra; Dilly M Little; D Mark Brooks; Hong K Kok; Hamed Asadi; Michael J Lee Journal: J Vasc Interv Radiol Date: 2019-04-26 Impact factor: 3.464
Authors: Frank J Veith; Richard A Baum; Takao Ohki; Max Amor; Mohan Adiseshiah; Jan D Blankensteijn; Jacob Buth; Timothy A M Chuter; Ronald M Fairman; Geoffrey Gilling-Smith; Peter L Harris; Kim J Hodgson; Brian R Hopkinson; Krassi Ivancev; Barry T Katzen; Michael Lawrence-Brown; George H Meier; Martin Malina; Michel S Makaroun; Juan C Parodi; Götz M Richter; Geoffrey D Rubin; Wolf J Stelter; Geoffrey H White; Rodney A White; Willem Wisselink; Christopher K Zarins Journal: J Vasc Surg Date: 2002-05 Impact factor: 4.268