The 'Sphere': A Dedicated Bifurcation Aneurysm Flow-Diverter Device.
We present flow-based results from the early stage design cycle, based on computational modeling, of a prototype flow-diverter device, known as the 'Sphere', intended to treat bifurcation aneurysms of the cerebral vasculature. The device is available in a range of diameters and geometries and is constructed from a single loop of NITINOL®wire. The 'Sphere' reduces aneurysm inflow by means of a high-density, patterned, elliptical surface that partially occludes the aneurysm neck. The device is secured in the healthy parent vessel by two armatures in the shape of open loops, resulting in negligible disruption of parent or daughter vessel flow. The device is virtually deployed in six anatomically accurate bifurcation aneurysms: three located at the Basilar tip and three located at the terminus bifurcation of the Internal Carotid artery (at the meeting of the middle cerebral and anterior cerebral arteries). Both steady state and transient flow simulations reveal that the device presents with a range of aneurysm inflow reductions, with mean flow reductions falling in the range of 30.6-71.8% across the different geometries. A significant difference is noted between steady state and transient simulations in one geometry, where a zone of flow recirculation is not captured in the steady state simulation. Across all six aneurysms, the device reduces the WSS magnitude within the aneurysm sac, resulting in a hemodynamic environment closer to that of a healthy vessel. We conclude from extensive CFD analysis that the 'Sphere' device offers very significant levels of flow reduction in a number of anatomically accurate aneurysm sizes and locations, with many advantages compared to current clinical cylindrical flow-diverter designs. Analysis of the device's mechanical properties and deployability will follow in future publications.
Institute of Biomedical Engineering, Department of Engineering Science, Oxford University, Oxford, UK.
Thomas
T
Peach
Minimally Invasive New Technologies Program, Weill-Cornell Medical College, New York, NY USA ; New York Presbyterian Hospital, New York, NY USA.
J Frederick
JF
Cornhill
Minimally Invasive New Technologies Program, Weill-Cornell Medical College, New York, NY USA ; New York Presbyterian Hospital, New York, NY USA.
Anh
A
Nguyen
Minimally Invasive New Technologies Program, Weill-Cornell Medical College, New York, NY USA ; New York Presbyterian Hospital, New York, NY USA ; Department of Neurosurgery, NYU Langone Medical Center, New York, NY USA.
Howard
H
Riina
Department of Mechanical Engineering, University College London, London, UK.
Yiannis
Y
Ventikos
CFD; Medical devices; Minimally invasive; Neurovascular; PED; SILK; Shear stress; Stent; Thrombosis; WEB; WSS