Assessing flow diverter porosity: a comparative analysis of quantification techniques based on imaging and simulation

Flow diverter porosity directly influences the blood flow reduction at the aneurysm neck level and the anatomical result of the treatment. In this research, we present and compare three methodologies to determine the local porosity of deployed flow diverters.

Three-dimensional rotational angiography was used to obtain computational vessel models of three patients. Different flow diverters were virtually deployed in the computational models and implanted in 3D-printed models of the vasculatures by interventional neuroradiologists. Experimental porosity determinations were conducted using 2D microscope photographs and 3D Dyna-CT images (i.e. cone-beam Computed Tomography angiographic images), while simulated porosity was computed using ANKYRAS software.

No statistically significant differences were observed between the porosity distributions from the three methods (p > 0.01). When computing the differences point-by-point, narrow distributions centered on zero were obtained, revealing a good agreement in the determinations. Orthogonal regression analysis affirmed this equivalence. The lowest agreement between porosity measurement methods was observed to occur at curve segments with relatively low porosity.

The local porosity of deployed flow diverters can be accurately determined by the three methods presented in this work. Assessing FD porosity with 3D Dyna-CT images would allow the evaluation of real patient data, whereas simulations could determine local porosity before the treatment.