4.3 Article

Experimental Analysis of Pressure and Flow Alterations During and After Insertion of a Multilayer Flow Modulator into an AAA Model with Incorporated Branch

Journal

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
Volume 44, Issue 8, Pages 1251-1259

Publisher

SPRINGER
DOI: 10.1007/s00270-021-02835-z

Keywords

Abdominal aortic aneurysm; Multilayer flow modulator; Endovascular deployment; Particle imaging velocimetry; Intra-aneurysmal pressure; Branch perfusion

Funding

  1. JSPS KAKENHI [JP18K18356, JP20H04557]
  2. ImPACT program of Council for Science, Technology and Innovation (Cabinet Office, Government of Japan)
  3. Cardiatis (Isnes, Belgium)

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The experimental study on the multilayer flow modulator (MFM) device showed that it effectively decreases intra-aneurysmal flow while preserving branch flow, reducing the risk of type II endoleak. The developed experimental system was effective in simulating endovascular procedures and assessing the safety and effectiveness of endovascular devices.
Purpose The multilayer flow modulator (MFM) device has been used for the treatment of abdominal aortic aneurysm (AAA) for over a decade. Although several clinical studies have been published, criticism and concern over the device efficacy remain, as no quantitative analysis that describes its mechanism has been performed yet. The aim of this study was to experimentally evaluate the effect of MFM device deployment on aneurysmal pressure and branch perfusion. Materials and Methods An experimental flow and pressure monitoring system was developed to analyze the MFM deployment procedure performed by a qualified radiologist in AAA geometries with and without side branch. Particle image velocimetry experiments were then conducted on models with and without MFM device to evaluate and compare flow patterns and local flow velocity and vorticity in the aneurysm. Results The experiments revealed no significant change in pressure and flow rate during and after deployment of the MFM device. The flow rate of the incorporated branch was fully preserved. On both models, the aneurysmal flow velocity was significantly reduced. In addition, the device modified local flow patterns, reducing vorticity and better feeding the incorporated branch. Conclusion This experimental study provides the basis for a better understanding of the mechanism of the MFM device, which allows intra-aneurysmal flow to decrease while preserving incorporated branch flow and reducing the risk of type II endoleak. The experimental system developed for this study was effective in simulating an endovascular procedure and studying the safety and effectiveness of endovascular devices.

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