Compacting a Single Flow Diverter versus Overlapping Flow Diverters for Intracranial Aneurysms: A Computational Study

Area of Science:

• Biomedical Engineering
• Medical Devices
• Computational Fluid Dynamics

Background:

• Intracranial aneurysms pose significant health risks.
• Flow diverters (FDs) are used to treat aneurysms by redirecting blood flow.
• Mesh compaction is a technique to enhance FD performance.

Purpose of the Study:

• To compare the efficacy of a single compacted FD versus two overlapped FDs for reducing blood flow in aneurysms.
• To investigate the relationship between FD compaction and aneurysm orifice area.

Main Methods:

• Simulated three FD strategies (single noncompacted, two overlapped, single compacted) in three aneurysm models (fusiform, large saccular, medium saccular) using virtual stent placement.
• Utilized computational fluid dynamics (CFD) to analyze hemodynamic parameters post-treatment.
• Examined the correlation between the degree of compaction and aneurysm orifice area.

Main Results:

• Single compacted FD achieved 57%, 47%, and 22% compaction coverage in fusiform, large saccular, and medium saccular aneurysms, respectively.
• Compaction coverage showed a linear increase with aneurysm orifice area.
• The single compacted FD outperformed the other strategies in flow reduction for the fusiform aneurysm.
• For saccular aneurysms, two overlapped FDs provided the most flow reduction, followed by the single compacted FD.

Conclusions:

• A single compacted FD can be more effective than two overlapped FDs for aneurysmal flow reduction.
• Optimal performance requires the compacted mesh to be denser than overlapped FDs and cover at least 50% of the aneurysm orifice.
• This technique is particularly beneficial for aneurysms with large orifices, such as fusiform aneurysms.