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Abstract TMP6: Computational Hemodynamic Analysis Of Intra-Aneurysmal Effects Due To Flow Diverter Stent Deployment Conformation


 Introduction:
 Inflow blockage of aneurysms treated with flow diverter stents is dependent on the deployed braid angle (ϕ)—the angle between the yarns which comprise the stent braids and the longitudinal axis of the braid. We utilized computational fluid dynamic (CFD) analysis to examine the effects of braid angle on intra-aneurysmal hemodynamic parameters associated with long-term treatment success.
 
 
 Methods:
 Two flow diverter stents measuring 3.5 mm in diameter, each containing 88 strands with ϕ = 10° and ϕ = 35° were constructed and deployed into a patient model of an internal carotid artery saccular aneurysm containing pulsatile blood flow. Intra-aneurysmal flow velocity, pulsatility index (PI), turbulence, vorticity, and wall shear stress (WSS) parameters were obtained and compared for the two braid angles.
 
 
 Results:
 Reducing ϕ from 35° to 10° resulted in -2.59%, -1.92%, and -1.41% changes in systolic bulk velocity, and -1.79%, +0.57%, and -1.65% changes in PI at the aneurysm neck, body, and dome respectively. Vorticity changes were insignificant. High turbulence extending through the aneurysm neck peaked approximately 0.04 s later in systole, and was located closer to the parent vessel outlet when ϕ = 10°. Elevated intra-aneurysmal WSS was concentrated at the neck and body on the side of the parent vessel outlet for both ϕ = 10° and ϕ = 35°. Regions of WSS in excess of 10 Pa stretched higher into the aneurysm body when ϕ = 35°.
 
 
 Conclusion:
 Stenting at a lower ϕ resulted in higher blockage of flow and better reduction of WSS for initiating and facilitating long term intra-aneurysmal thrombosis. CFD analysis incorporating precise reconstruction of the stent deployment conformation into patient models can provide detailed visualization of flow parameters for assessing potential treatment efficacy throughout the diagnostic and treatment phases of patient care.
 
 
 
