How Flow Diverter Selection Can Affect the Flow Changes within a Jailed Ophthalmic Artery: A Computational Fluid...

Area of Science:

• Biomedical Engineering
• Medical Imaging
• Computational Fluid Dynamics

Background:

• Flow diverter (FD) stents are utilized for treating giant aneurysms by decreasing blood flow.
• Optimal FD selection is complex when nearby arteries, like the ophthalmic artery (OA), are compromised during placement.

Purpose of the Study:

• To compare the impact of two FD stents with varying effective metal surface area (EMSA) on OA occlusion.
• To evaluate the risk of ocular ischemic syndrome associated with jailed OA by different FD stents.

Main Methods:

• A numerical model was developed based on clinical data of a patient with a giant aneurysm and a jailed OA.
• Two FD stents (FRED4017 and FRED4518) with different EMSA values were virtually deployed.
• Simulations were performed to compare blood flow and OA occlusion between the two FD stents.

Main Results:

• FRED4017 exhibited higher EMSA at the aneurysm neck (35% vs. 24.6%) and lower EMSA at the OA inlet (15% vs. 21.2%) compared to FRED4518.
• FRED4017 resulted in greater OA occlusion (40% vs. 28%), suggesting an increased risk of ocular ischemic syndrome.

Conclusions:

• The EMSA of FD stents significantly influences blood flow and occlusion in a jailed OA.
• Selecting FD stents with lower EMSA at the OA inlet is recommended for patients with jailed arteries near the aneurysm neck.