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Abstract Details

A Case of Early Rupture Following Flow-Diversion with Quantification of Hemodynamics and Aneurysmal Wall Stress using Additive Manufacturing and Particle Tracking Velocimetry
Cerebrovascular Disease and Interventional Neurology
P13 - Poster Session 13 (5:30 PM-6:30 PM)
4-006
A left ophthalmic aneurysm following treatment with a flow-diverting stent (FDS) had early rupture, for which fluid mechanical experimental analysis was preformed to quantify the changes in hemodynamics in a three dimensional model of the aneurysm.l
Early rupture following treatment is a rare but devastating complication of flow diversion in fusiform aneurysms.  Computational models have provided theories of mechanisms by which flow-diversion can lead to early rupture, but fluid mechanical experiments have demonstrated computational models fail to accurately predict flow.
Angiographic reconstructions of the aneurysm were exported in digital format and model silicone vessels were fabricated.  The model aneurysm was submerged in deionized water with Glycerol to match the refractive index of the silicon model and reduce optical distortion.  Rhodium B coated microparticles were suspended in model blood and pumped through the aneurysm using a pulsatile blood pump. The heart rate and blood pressure were matched to the patient.  Time dependent flow within the aneurysm was quantified using the three-dimensional particle tracking velocimetry technique termed “Shake the Box,” which reconstructs the flow vectors within the aneurysm.
Stented flow had higher resistance compared to non-stented flow until a velocity of 80cm/s. Additionally, stented flow transitioned from non-laminar flow to a laminar flow within physiologic flow velocities (25cm/s). There was visually noticeable traction of the stent on the parent and daughter vessels with each pulse of flow.
While we were able to quantitatively understand the pressure drop and change in resistance of flow that occurred in the aneurysm, no intuitive findings for the mechanism of rupture were discovered. However, potential new hypotheses for causes of aneurysm rupture were discovered, requiring future testing. This study supports previous literature that there are many complex changes that occur in placement of a FDS, making it difficult to predict outcomes and improve patient selection.
Authors/Disclosures
Melissa Cook, MD
PRESENTER 		Dr. Cook has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Adam M. Willis, MD The institution of Dr. Willis has received research support from Air Force. Dr. Willis has received intellectual property interests from a discovery or technology relating to health care.