A new model for the construction of virtual fully resolved flow-diverters

Endovascular devices and procedures have substantially evolved to be one of the principal alternatives to treat intracranial aneurysms.

Thanks to advances in technology, improvements on imaging and a growing market on minimally invasive surgery devices, nowadays medical practitioners have a wider set of treatment options to make an objective decision nearly adapted to the specific condition of the patient. Nevertheless, many questions about the effect of these devices in the aneurysm healing process remain open, requiring a better and deeper study of these methods by combining numerical and virtual approaches with patient-specific data.

During Thrombus project, a new virtual flow-diverter (FD) stent model was developed in order to study hemodynamics within the aneurysm and the parent vessel before and after the endovascular intervention. This method is based on a right generalized cylinder model that allows mapping fully resolved FDs on the surface of a reconstructed cylinder, e.g. a patient-specific parent vessel. Moreover, the software permits to simulate the deployment process requiring as input: a) the patient-specific vessel and aneurysm 3D reconstructions, b) the parent vessel centerline, and c) a custom configuration with the common characteristics of a FD (number of struts, stent diameter, strut diameter...).

 

We continue working in new perspectives for the study of FD devices thanks to the flexibility of the method to adapt recent techniques in the treatment of intracranial aneurysms. For example, an extension to the basic deployment method was developed to use more than one FD by telescoping one device into another, a common requirement in medical practice to achieve considerable flow modification or to cross aneurysms with large necks. Additionally, a new deployment method considering physical properties of the vessel and the catheter has been added to get closer to the practitioners’ gestures during the intervention.

 

Telescope

This part of the project is the result of a close collaboration between CREATIS laboratory (France) and Pontificia Universidad Javeriana (Colombia). Special thanks to Prof. Leonardo Flórez for the theoretical conception of the method and its implementation, as well as Juan Gabriel Riveros for his support in the software development process.