Angiographic analysis for phantom simulations of endovascular aneurysm treatments with a new fully retrievable asymmetric flow diverter

Aradhana Yoganand; Rachel P. Wood; Carlos Jimenez; Adnan Siddiqui M.D.; Kenneth Snyder; S. V. Setlur Nagesh; D. R. Bednarek; S. Rudin; Robert Baier; Ciprian N Ionita

doi:10.1117/12.2082079

17 March 2015 Angiographic analysis for phantom simulations of endovascular aneurysm treatments with a new fully retrievable asymmetric flow diverter

Aradhana Yoganand, Rachel P. Wood, Carlos Jimenez, Adnan Siddiqui M.D., Kenneth Snyder, S. V. Setlur Nagesh, D. R. Bednarek, S. Rudin, Robert Baier, Ciprian N Ionita

Author Affiliations +

Proceedings Volume 9417, Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging; 94170W (2015) https://doi.org/10.1117/12.2082079
Event: SPIE Medical Imaging, 2015, Orlando, Florida, United States

Abstract

Digital Subtraction Angiography (DSA) is the main diagnostic tool for intracranial aneurysms (IA) flow-diverter (FD) assisted treatment. Based on qualitative contrast flow evaluation, interventionists decide on subsequent steps. We developed a novel fully Retrievable Asymmetric Flow-Diverter (RAFD) which allows controlled deployment, repositioning and detachment achieve optimal flow diversion. The device has a small low porosity or solid region which is placed such that it would achieve maximum aneurysmal in-jet flow deflection with minimum impairment to adjacent vessels. We tested the new RAFD using a flow-loop with an idealized and a patient specific IA phantom in carotid-relevant physiological conditions. We positioned the deflection region at three locations: distally, center and proximally to the aneurysm orifice and analyzed aneurysm dome flow using DSA derived maps for mean transit time (MTT) and bolus arrival times (BAT). Comparison between treated and untreated (control) maps quantified the RAFD positioning effect. Average MTT, related to contrast presence in the aneurysm dome increased, indicating flow decoupling between the aneurysm and parent artery. Maximum effect was observed in the center and proximal position (~75%) of aneurysm models depending on their geometry. BAT maps, correlated well with inflow jet direction and magnitude. Reduction and jet dispersion as high as about 50% was observed for various treatments. We demonstrated the use of DSA data to guide the placement of the RAFD and showed that optimum flow diversion within the aneurysm dome is feasible. This could lead to more effective and a safer IA treatment using FDs.

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Aradhana Yoganand, Rachel P. Wood, Carlos Jimenez, Adnan Siddiqui M.D., Kenneth Snyder, S. V. Setlur Nagesh, D. R. Bednarek, S. Rudin, Robert Baier, and Ciprian N Ionita "Angiographic analysis for phantom simulations of endovascular aneurysm treatments with a new fully retrievable asymmetric flow diverter", Proc. SPIE 9417, Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging, 94170W (17 March 2015); https://doi.org/10.1117/12.2082079

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