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High Fidelity Virtual Stenting (HiFiVS) for Intracranial Aneurysm Flow Diversion: In Vitro and In Silico

机译:用于颅内动脉瘤血流转移的高保真虚拟支架(HiFiVS):体外和计算机模拟

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摘要

A flow diverter (FD) is a flexible, densely braided stent-mesh device placed endoluminally across an intracranial aneurysm to induce its thrombotic occlusion. FD treatment planning using computational virtual stenting and flow simulation requires accurate representation of the expanded FD geometry. We have recently developed a High Fidelity Virtual Stenting (HiFiVS) technique based on finite element analysis to simulate detailed FD deployment processes in patient-specific aneurysms (Ma et al. J. Biomech. 45: 2256–2263, 2012). This study tests if HiFiVS simulation can recapitulate real-life FD implantation. We deployed two identical FDs (Pipeline Embolization Device) into phantoms of a wide-necked segmental aneurysm using a clinical push-pull technique with different delivery wire advancements. We then simulated these deployment processes using HiFiVS and compared results against experimental recording. Stepwise comparison shows that the simulations precisely reproduced the FD deployment processes recorded in vitro. The local metal coverage rate and pore density quantifications demonstrated that simulations reproduced detailed FD mesh geometry. These results provide validation of the HiFiVS technique, highlighting its unique capability of accurately representing stent intervention in silico.
机译:分流器(FD)是一种柔性,密集编织的支架网状装置,位于腔内横穿颅内动脉瘤以引起其血栓闭塞。使用计算虚拟支架和流动模拟进行FD治疗计划需要精确表示扩展的FD几何形状。我们最近开发了一种基于有限元分析的高保真虚拟支架(HiFiVS)技术,以模拟特定患者动脉瘤中详细的FD部署过程(Ma等人,J。Biomech。45:2256-2263,2012)。这项研究测试了HiFiVS仿真是否可以概括真实的FD植入。我们使用临床推挽技术和不同的送丝方式将两个相同的FD(管道栓塞装置)部署到宽颈节段性动脉瘤的模型中。然后,我们使用HiFiVS模拟了这些部署过程,并将结果与​​实验记录进行了比较。逐步比较表明,模拟精确地再现了体外记录的FD部署过程。局部金属覆盖率和孔密度量化表明,模拟再现了详细的FD网格几何形状。这些结果提供了对HiFiVS技术的验证,突出了其在计算机中准确表示支架介入的独特能力。

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