颅内动脉瘤个体化血流导向治疗新概念:设计要点与体外流体动力学。

New Concept of Patient-specific Flow Diversion Treatment of Intracranial Aneurysms : Design Aspects and in vitro Fluid Dynamics.

机构信息

Acandis GmbH, R&D, Pforzheim, Baden-Württemberg, Germany.

, Weltzienstr. 24, 76135, Karlsruhe, Germany.

出版信息

Clin Neuroradiol. 2021 Sep;31(3):671-679. doi: 10.1007/s00062-020-00930-1. Epub 2020 Jul 10.

Abstract

PURPOSE

Current flow diverter (FD) designs limit the possibilities to achieve ideal functional parameters for intra-aneurysmal flow alteration in the implanted state. In this work, we evaluate the technical feasibility of a new patient-specific FD concept and the impact on intra-aneurysmal flow reduction compared to standard FD.

METHODS

Based on a literature review, we defined functional requirements, followed by the design and manufacturing of two different prototypes, which we implanted in a patient-specific phantom model. Functional porosity distributions and contour parameters were evaluated in the implanted state and compared to standard FD. Subsequently, we carried out a series of particle image velocimetry (PIV) measurements, in order to assess the impact on intra-aneurysmal flow.

RESULTS

With both patient-specific prototypes, it was possible to achieve stronger intra-aneurysmal flow reductions in terms of maximum and mean velocity and vorticity than a standard FD; however, one design showed a strong sensitivity against malpositioning. Overall, fluid dynamics parameters correlated with geometrical aspects such as the porosity and its grade of homogeneity. Beyond that, we found influences by the FD contour projection within the aneurysm, especially connected to the formation of in-jets.

CONCLUSION

Our results show that there is a technically feasible concept, which enables a more specific adjustment of functional FD parameters and more effective intra-aneurysmal flow reduction. This could potentially lead to improvements in the efficacy of aneurysm occlusion in cases with challenging fluid dynamics.

摘要

目的

目前的血流分流器(FD)设计限制了在植入状态下实现理想的腔内血流改变功能参数的可能性。在这项工作中,我们评估了一种新的患者特异性 FD 概念的技术可行性,并与标准 FD 相比评估了对腔内血流减少的影响。

方法

基于文献综述,我们定义了功能要求,随后设计和制造了两种不同的原型,将其植入患者特异性模型中。在植入状态下评估了功能孔隙率分布和轮廓参数,并与标准 FD 进行了比较。随后,我们进行了一系列粒子图像测速(PIV)测量,以评估对腔内血流的影响。

结果

使用两种患者特异性原型,与标准 FD 相比,最大和平均速度和涡度的腔内血流减少更明显;然而,一个设计对错位显示出强烈的敏感性。总体而言,流体动力学参数与孔隙率及其均匀度等级等几何方面相关。除此之外,我们还发现 FD 在动脉瘤内的轮廓投影会产生影响,特别是与射流的形成有关。

结论

我们的结果表明,有一种技术上可行的概念,可以更具体地调整 FD 的功能参数,并更有效地减少腔内血流。这可能会提高在具有挑战性的流体动力学情况下进行动脉瘤闭塞的疗效。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索