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

  • SUNY Buffalo
  • Universidad de Antioquia

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

4 Scopus citations

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.

Original languageEnglish
Title of host publicationMedical Imaging 2015
Subtitle of host publicationBiomedical Applications in Molecular, Structural, and Functional Imaging
EditorsBarjor Gimi, Robert C. Molthen
PublisherSPIE
ISBN (Electronic)9781628415070
DOIs
StatePublished - 2015
EventMedical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging - Orlando, United States
Duration: Feb 24 2015Feb 26 2015

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume9417
ISSN (Print)1605-7422

Conference

ConferenceMedical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging
Country/TerritoryUnited States
CityOrlando
Period02/24/1502/26/15

Keywords

  • Asymmetric flow diverter (AFD)
  • Bolus arrival time (BAT)
  • Digital subtraction angiography (DSA)
  • Flow diverter (FD)
  • Intracranial aneurysm (IA)
  • Mean transit time (MTT)
  • Parametric image mapping (PIM)
  • Retrievable asymmetric flow diverter (RAFD)
  • Uniform flow diverter (UFD)

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