PMID- 37852752
OWN - NLM
STAT- Publisher
LR  - 20231024
IS  - 1759-8486 (Electronic)
IS  - 1759-8478 (Linking)
DP  - 2023 Oct 18
TI  - In vitro and in silico assessment of flow modulation after deploying the Contour 
      Neurovascular System in intracranial aneurysm models.
LID - jnis-2023-020403 [pii]
LID - 10.1136/jnis-2023-020403 [doi]
AB  - BACKGROUND: The novel Contour Neurovascular System (Contour) has been reported to 
      be efficient and safe for the treatment of intracranial, wide-necked bifurcation 
      aneurysms. Flow in the aneurysm and posterior cerebral arteries (PCAs) after 
      Contour deployment has not been analyzed in detail yet. However, this information 
      is crucial for predicting aneurysm treatment outcomes. METHODS: Time-resolved 
      three-dimensional velocity maps in 14 combinations of patient-based basilar tip 
      aneurysm models with and without Contour devices (sizes between 5 and 14 mm) were 
      analyzed using four-dimensionsal (4D) flow MRI and numerical/image-based flow 
      simulations. A complex virtual processing pipeline was developed to mimic the 
      experimental shape and position of the Contour together with the simulations. 
      RESULTS: On average, the Contour significantly reduced intra-aneurysmal flow 
      velocity by 67% (mean w/ = 0.03m/s; mean w/o = 0.12m/s; p-value=0.002), and the 
      time-averaged wall shear stress by more than 87% (mean w/ = 0.17Pa; mean w/o = 
      1.35Pa; p-value=0.002), as observed by numerical simulations. Furthermore, a 
      significant reduction in flow (P<0.01) was confirmed by the neck inflow rate, 
      kinetic energy, and inflow concentration index after Contour deployment. Notably, 
      device size has a stronger effect on reducing flow than device positioning. 
      However, positioning affected flow in the PCAs, while being robust in effectively 
      reducing flow. CONCLUSIONS: This study showed the high efficacy of the Contour 
      device in reducing flow within aneurysms regardless of the exact position. 
      However, we observed an effect on the flow in PCAs, which needs to be 
      investigated further.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Korte, Jana
AU  - Korte J
AUID- ORCID: 0000-0002-0434-712X
AD  - Laboratory of Fluid Dynamics and Technical Flows, University of Magdeburg, 
      Magdeburg, Germany korte.j@outlook.com.
AD  - Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany.
FAU - Gaidzik, Franziska
AU  - Gaidzik F
AUID- ORCID: 0000-0003-1924-821X
AD  - Laboratory of Fluid Dynamics and Technical Flows, University of Magdeburg, 
      Magdeburg, Germany.
AD  - Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany.
FAU - Larsen, Naomi
AU  - Larsen N
AUID- ORCID: 0000-0002-8782-8278
AD  - Department of Radiology and Neuroradiology, University Medical Center 
      Schleswig-Holstein (UKSH), Kiel, Germany.
FAU - Schutz, Erik
AU  - Schutz E
AD  - Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany.
FAU - Damm, Timo
AU  - Damm T
AD  - Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), 
      Department of Radiology and Neuroradiology, University Medical Center 
      Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany.
FAU - Wodarg, Fritz
AU  - Wodarg F
AUID- ORCID: 0000-0003-1413-2699
AD  - Department of Radiology and Neuroradiology, University Medical Center 
      Schleswig-Holstein (UKSH), Kiel, Germany.
FAU - Hovener, Jan-Bernd
AU  - Hovener JB
AD  - Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), 
      Department of Radiology and Neuroradiology, University Medical Center 
      Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany.
FAU - Jansen, Olav
AU  - Jansen O
AD  - Department of Radiology and Neuroradiology, University Medical Center 
      Schleswig-Holstein (UKSH), Kiel, Germany.
FAU - Janiga, Gabor
AU  - Janiga G
AUID- ORCID: 0000-0002-4560-9640
AD  - Laboratory of Fluid Dynamics and Technical Flows, University of Magdeburg, 
      Magdeburg, Germany.
AD  - Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany.
FAU - Berg, Philipp
AU  - Berg P
AUID- ORCID: 0000-0003-4140-6771
AD  - Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany.
AD  - Department of Healthcare Telematics and Medical Engineering, University of 
      Magdeburg, Magdeburg, Germany.
FAU - Pravdivtseva, Mariya S
AU  - Pravdivtseva MS
AUID- ORCID: 0000-0001-9442-088X
AD  - Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), 
      Department of Radiology and Neuroradiology, University Medical Center 
      Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany.
LA  - eng
PT  - Journal Article
DEP - 20231018
PL  - England
TA  - J Neurointerv Surg
JT  - Journal of neurointerventional surgery
JID - 101517079
SB  - IM
OTO - NOTNLM
OT  - Aneurysm
OT  - Blood Flow
OT  - CT
OT  - Device
OT  - MRI
COIS- Competing interests: The author(s) declared the following potential conflicts of 
      interest with respect to the research, of this article: MSP has received a 
      research grant from Cerus endovascular; FW has received fees for consulting and 
      speaking from Balt International SAS and Cerus Endovascular.
EDAT- 2023/10/19 00:44
MHDA- 2023/10/19 00:44
CRDT- 2023/10/18 21:13
PHST- 2023/04/06 00:00 [received]
PHST- 2023/07/15 00:00 [accepted]
PHST- 2023/10/19 00:44 [pubmed]
PHST- 2023/10/19 00:44 [medline]
PHST- 2023/10/18 21:13 [entrez]
AID - jnis-2023-020403 [pii]
AID - 10.1136/jnis-2023-020403 [doi]
PST - aheadofprint
SO  - J Neurointerv Surg. 2023 Oct 18:jnis-2023-020403. doi: 10.1136/jnis-2023-020403.