In vitro and in silico study of intracranial stent treatments for cerebral aneurysms: effects on perforating vessel flows.
BACKGROUND
Many cerebral aneurysms can be treated effectively with intracranial stents. Unfortunately, stents can occlude perforating vessels near the treatment site which can decrease cerebral perfusion and increase the risk of stroke.


METHODS
Particle image velocimetry was used to investigate the effects of intracranial stents on flows in perforators near a treated aneurysm. In Phase 1 of the study, different stent configurations were deployed into an idealized physical model of a sidewall aneurysm with perforating vessels. The configurations investigated were the Pipeline embolization device (PED) and one, two and three telescoping Neuroform stents. In Phase 2 of the study a single Neuroform stent was deployed so that the stent struts directly occluded the perforating vessel.


RESULTS
In Phase 1 of the study it was found that even three telescoping stents affected perforating vessel flow less than a single PED under pulsatile conditions (average reduction 32.7% vs 46.5%). Results from Phase 2 indicated that the location of the occluding strut across the perforating vessel orifice had a greater impact on perforating vessel flow than the percentage occlusion.


CONCLUSIONS
The findings of this study show that the use, configuration and positioning of intracranial stents can all have considerable influence on flow in affected perforating vessels near treated cerebral aneurysms.
School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85287–9709, USA. Breigh.Roszelle@asu.edu
Breigh Nonte
BN
Roszelle
M Haithem
MH
Babiker
Walter
W
Hafner
L Fernando
LF
Gonzalez
Felipe C
FC
Albuquerque
David H
DH
Frakes
D001783:Blood Flow Velocity / Q000502:physiology*; D003198:Computer Simulation; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D057446:Hydrodynamics; D002532:Intracranial Aneurysm / Q000503:physiopathology / Q000628:therapy*; D012212:Rheology / Q000295:instrumentation / Q000379:methods; D015607:Stents; D016896:Treatment Outcome