An in vitro study of pulsatile fluid dynamics in intracranial aneurysm models treated with embolic coils and flow diverters

M. Haithem Babiker, L. Fernando Gonzalez, Felipe Albuquerque, Daniel Collins, Arius Elvikis, Christine Zwart, Breigh Roszelle, David Frakes

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Although coil embolization is one of the most effective treatments for intracranial aneurysms (ICAs), the procedure is often unsuccessful. For example, an ICA may persist after coil embolization if deployed coils fail to block the flow of blood into the aneurysm. Unfortunately, the specific flow changes that are effected by embolic coiling (and other endovascular therapies) are poorly understood, which creates a barrier to the design and execution of optimal treatments in the clinic. We present an in vitro pulsatile flow study of treated basilar tip aneurysm models that elucidates relationships between controllable treatment parameters and clinically important post-treatment fluid dynamics. We also compare fluid dynamic performance across embolic coils and more recently proposed devices (e.g., the Pipeline Embolization Device) that focus on treating ICAs by diverting rather than blocking blood flow. In agreement with previous steady flow studies, coil embolization-reduced velocity magnitude at the aneurysmal neck by greater percentages for a narrow-neck aneurysm, and reduced flow into aneurysms by greater percentages at lower parent vessel flow rates. However, flow diversion reduced flow into a wide-neck aneurysm more so than coil embolization, regardless of flow conditions. Finally, results also showed that for the endovascular devices we examined, treatment effects were generally less dramatic under physiologic pulsatile flow conditions as compared to steady flow conditions. The fluid dynamic performance data presented in this study represent the first direct in vitro comparison of coils and flow diverters in aneurysm models, and provide a novel, quantitative basis to aid in designing endovascular treatments toward specific fluid dynamic outcomes.

Original languageEnglish (US)
Article number6357227
Pages (from-to)1150-1159
Number of pages10
JournalIEEE Transactions on Biomedical Engineering
Volume60
Issue number4
DOIs
StatePublished - Mar 25 2013

    Fingerprint

Keywords

  • Basilar artery
  • PIV
  • embolic coils
  • flow diverter
  • intracranial aneurysm (ICA)
  • packing density
  • pulsatile flow

ASJC Scopus subject areas

  • Biomedical Engineering

Cite this