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In vitro evaluation of flow diverter performance using a human fibrinogen-based flow model
Cem Bilgin1, Esref Alperen Bayraktar1, Alexander A Oliver1
1Departments of1Radiology and.
Journal of Neurosurgery
|July 12, 2024
Summary
This study developed a new in vitro model to study fibrin deposition on flow diverters for aneurysm treatment. Higher flow rates and thrombin significantly increased fibrin coverage, crucial for healing.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Biomaterials Science
Background:
- Fibrin deposition is vital for aneurysm occlusion and healing.
- Flow diverters are used to treat aneurysms by promoting natural healing processes.
- Understanding fibrin deposition on flow diverters is key to optimizing their efficacy.
Purpose of the Study:
- To introduce a novel in vitro testing platform for flow diverters using human fibrinogen.
- To investigate the influence of flow rates, anatomical configurations, and additives on fibrin deposition.
- To assess the role of flow characteristics like velocity and shear stress in fibrin accumulation.
Main Methods:
- A flow diverter was tested in four distinct glass models simulating different aneurysm angulations.
- Human fibrinogen was circulated at varying flow rates (0-5 ml/sec) with or without heparin, calcium chloride, and thrombin.
- Computational fluid dynamics analyzed flow characteristics, and ANOVA/Tukey tests assessed deposition rates.
Main Results:
- Fibrin deposition was minimal under static conditions but increased significantly with higher flow rates (5 ml/sec vs. 3 ml/sec).
- Anatomical models with higher inflow velocity (paraophthalmic) and shear stress (bifurcation) showed significantly greater fibrin deposition.
- Thrombin addition markedly enhanced fibrin deposition rates across all tested configurations (p = 0.001).
Conclusions:
- Fibrin deposition rates on flow diverters are highly variable, influenced by anatomical geometry, flow dynamics, and thrombin concentration.
- Fibrin accumulation initiates at the aneurysm inflow zone with high velocity and shear stress.
- This fibrinogen-based in vitro model provides valuable insights into flow diverter performance and aneurysm healing, warranting further clinical investigation.
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