In vitro and in silico assessment of flow modulation after deploying the Contour Neurovascular System in intracranial aneurysm models

BackgroundThe novel Contour Neurovascular System (Contour) has been reported to be efficient and safe for the treatment of intracranial, wide-necked bifurcation aneurysms. Flow in the aneurysm and posterior cerebral arteries (PCAs) after Contour deployment has not been analyzed in detail yet. Howeve...

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Published inJournal of neurointerventional surgery Vol. 16; no. 8; p. 815
Main Authors Korte, Jana, Gaidzik, Franziska, Larsen, Naomi, Schütz, Erik, Damm, Timo, Wodarg, Fritz, Hövener, Jan-Bernd, Jansen, Olav, Janiga, Gábor, Berg, Philipp, Pravdivtseva, Mariya S
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Abstract BackgroundThe novel Contour Neurovascular System (Contour) has been reported to be efficient and safe for the treatment of intracranial, wide-necked bifurcation aneurysms. Flow in the aneurysm and posterior cerebral arteries (PCAs) after Contour deployment has not been analyzed in detail yet. However, this information is crucial for predicting aneurysm treatment outcomes.MethodsTime-resolved three-dimensional velocity maps in 14 combinations of patient-based basilar tip aneurysm models with and without Contour devices (sizes between 5 and 14 mm) were analyzed using four-dimensionsal (4D) flow MRI and numerical/image-based flow simulations. A complex virtual processing pipeline was developed to mimic the experimental shape and position of the Contour together with the simulations.ResultsOn average, the Contour significantly reduced intra-aneurysmal flow velocity by 67% (mean w/ = 0.03m/s; mean w/o = 0.12m/s; p-value=0.002), and the time-averaged wall shear stress by more than 87% (mean w/ = 0.17Pa; mean w/o = 1.35Pa; p-value=0.002), as observed both by numerical simulations and 4D flow MRI. Furthermore, a significant reduction in flow (P<0.01) was confirmed by the neck inflow rate, kinetic energy, and inflow concentration index after Contour deployment. Notably, device size has a stronger effect on reducing flow than device positioning. However, positioning affected flow in the PCAs, while being robust in effectively reducing flow.ConclusionsThis study showed the high efficacy of the Contour device in reducing flow within aneurysms regardless of the exact position. However, we observed an effect on the flow in PCAs, which needs to be investigated further.
AbstractList BackgroundThe novel Contour Neurovascular System (Contour) has been reported to be efficient and safe for the treatment of intracranial, wide-necked bifurcation aneurysms. Flow in the aneurysm and posterior cerebral arteries (PCAs) after Contour deployment has not been analyzed in detail yet. However, this information is crucial for predicting aneurysm treatment outcomes.MethodsTime-resolved three-dimensional velocity maps in 14 combinations of patient-based basilar tip aneurysm models with and without Contour devices (sizes between 5 and 14 mm) were analyzed using four-dimensionsal (4D) flow MRI and numerical/image-based flow simulations. A complex virtual processing pipeline was developed to mimic the experimental shape and position of the Contour together with the simulations.ResultsOn average, the Contour significantly reduced intra-aneurysmal flow velocity by 67% (mean w/ = 0.03m/s; mean w/o = 0.12m/s; p-value=0.002), and the time-averaged wall shear stress by more than 87% (mean w/ = 0.17Pa; mean w/o = 1.35Pa; p-value=0.002), as observed both by numerical simulations and 4D flow MRI. Furthermore, a significant reduction in flow (P<0.01) was confirmed by the neck inflow rate, kinetic energy, and inflow concentration index after Contour deployment. Notably, device size has a stronger effect on reducing flow than device positioning. However, positioning affected flow in the PCAs, while being robust in effectively reducing flow.ConclusionsThis study showed the high efficacy of the Contour device in reducing flow within aneurysms regardless of the exact position. However, we observed an effect on the flow in PCAs, which needs to be investigated further.
The novel Contour Neurovascular System (Contour) has been reported to be efficient and safe for the treatment of intracranial, wide-necked bifurcation aneurysms. Flow in the aneurysm and posterior cerebral arteries (PCAs) after Contour deployment has not been analyzed in detail yet. However, this information is crucial for predicting aneurysm treatment outcomes. Time-resolved three-dimensional velocity maps in 14 combinations of patient-based basilar tip aneurysm models with and without Contour devices (sizes between 5 and 14 mm) were analyzed using four-dimensionsal (4D) flow MRI and numerical/image-based flow simulations. A complex virtual processing pipeline was developed to mimic the experimental shape and position of the Contour together with the simulations. On average, the Contour significantly reduced intra-aneurysmal flow velocity by 67% (mean w/ = 0.03m/s; mean w/o = 0.12m/s; p-value=0.002), and the time-averaged wall shear stress by more than 87% (mean w/ = 0.17Pa; mean w/o = 1.35Pa; p-value=0.002), as observed by numerical simulations. Furthermore, a significant reduction in flow (P<0.01) was confirmed by the neck inflow rate, kinetic energy, and inflow concentration index after Contour deployment. Notably, device size has a stronger effect on reducing flow than device positioning. However, positioning affected flow in the PCAs, while being robust in effectively reducing flow. This study showed the high efficacy of the Contour device in reducing flow within aneurysms regardless of the exact position. However, we observed an effect on the flow in PCAs, which needs to be investigated further.
Author Janiga, Gábor
Wodarg, Fritz
Jansen, Olav
Korte, Jana
Larsen, Naomi
Hövener, Jan-Bernd
Gaidzik, Franziska
Schütz, Erik
Pravdivtseva, Mariya S
Berg, Philipp
Damm, Timo
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  surname: Pravdivtseva
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/37852752$$D View this record in MEDLINE/PubMed
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CitedBy_id crossref_primary_10_3390_bioengineering11010072
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Keywords CT
Blood Flow
MRI
Device
Aneurysm
Language English
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Snippet BackgroundThe novel Contour Neurovascular System (Contour) has been reported to be efficient and safe for the treatment of intracranial, wide-necked...
The novel Contour Neurovascular System (Contour) has been reported to be efficient and safe for the treatment of intracranial, wide-necked bifurcation...
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SubjectTerms 3-D printers
Aneurysm
Aneurysms
Blood Flow
Blood Flow Velocity - physiology
CAD
Cerebrovascular Circulation - physiology
Computer aided design
Computer Simulation
Device
Embolization
Endovascular Procedures - methods
Fluid dynamics
Hemodynamics
Humans
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - physiopathology
MRI
New devices and techniques
Posterior Cerebral Artery - diagnostic imaging
Posterior Cerebral Artery - physiopathology
Sensors
Simulation
Transplants & implants
Veins & arteries
Velocity
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Title In vitro and in silico assessment of flow modulation after deploying the Contour Neurovascular System in intracranial aneurysm models
URI http://dx.doi.org/10.1136/jnis-2023-020403
https://www.ncbi.nlm.nih.gov/pubmed/37852752
https://www.proquest.com/docview/2880849750
Volume 16
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