PT  - JOURNAL ARTICLE
AU  - Darsaut, T.E.
AU  - Bing, F.
AU  - Salazkin, I.
AU  - Gevry, G.
AU  - Raymond, J.
TI  - Flow Diverters Can Occlude Aneurysms and Preserve Arterial Branches: A New Experimental Model
AID  - 10.3174/ajnr.A3075
DP  - 2012 Nov 01
TA  - American Journal of Neuroradiology
PG  - 2004--2009
VI  - 33
IP  - 10
4099  - http://www.ajnr.org/content/33/10/2004.short
4100  - http://www.ajnr.org/content/33/10/2004.full
SO  - Am. J. Neuroradiol.2012 Nov 01; 33
AB  - BACKGROUND AND PURPOSE: FDs are new intracranial stents designed to occlude aneurysms while preserving flow to jailed arterial branches. We tested this fundamental principle in a new aneurysm model. MATERIALS AND METHODS: Canine lateral wall aneurysms, featuring a branch located immediately opposite the aneurysm, were created in 16 animals to study the effects on aneurysm or branch occlusion using single HP stents (n = 4), 2 overlapping HP stents (n = 4), or an FD (n = 8). Two other animals, in which an efferent arterial branch was anastomosed to the aneurysm fundus, were also treated with FDs. Angiographic results after deployment, at 2 weeks, and at 3 months were scored using an ordinal scale. The metal porosity of the FSS and the amount of FSS neointima formation was determined by postmortem photography. RESULTS: FDs led to better angiographic occlusion scores compared with HP stents (P = .026). FDs were significantly more likely to occlude the aneurysm than the branch (P = .01). When the branch was switched to originate from the aneurysm fundus, the FDs became ineffective (0/2). Neointimal closure of the aneurysm ostium was significantly better with FDs than with single or double HP stents (P = .039). Angiographic occlusion correlated with metallic porosity and neointimal tissue coverage (Spearman ρ = −0.81; P = .001). CONCLUSIONS: In this study, flow diverters occluded lateral wall aneurysms more readily than branches. Metal device porosity strongly influenced the occlusion rate. ASAaspirinCCAcommon carotid arteryCFDcomputational fluid dynamicsFDflow divertersFSSfree segment of stentHPhigh- porosity