Aneurysm flow dynamics: alterations of slipstream flow for neuroendovascular treatment with liquid embolic agents.

摘要: BACKGROUND AND PURPOSE: The main issue with use of a liquid embolic agent is one safety. To determine and improve the efficacy potential neuroendovascular treatment regimens, particularly agents, we evaluated changes in aneurysm flow dynamics resulting from alterations parent vessel flow. METHODS: We created silicone replicas laboratory-created model basilar artery cast human cadaver. Replicas were placed circuit pulsatile non-Newtonian fluid, flows adjusted to simulate physiologic velocity, profile, volume. Individual fluid slipstreams opacified isobaric dyes. Images obtained unaltered vascular replica; after placement nondetachable balloon at multiple locations proximal to, across, distal neck; stent across neck. Aneurysms then occluded cyanoacrylate association each device. RESULTS: In replica, entered neck impacted against lateral wall. Disturbed, but nonturbulent, continued along wall vortex pattern exited aspect With partially inflated vessel, slipstream velocity increased. This resulted more rapid sac, less favorable condition for deposition material. effect was pronounced greater degrees inflation (resulting narrowing) when compared positioning. Only complete occlusion lumen, either or there intraaneurysmal reduction (ie, stasis), material deposition. Also, positioned neck, not only did remain also surface could be molded re-create normal lumen. A caused lose their coherence as they passed through mesh. prevented impact sidewall decreased velocity. During into mesh appeared provide barrier passage adjacent CONCLUSION: Knowledge incurred endovascular alteration provides basis safer obliteration by using neurointerventional technique.