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Erschienen in: Clinical Neuroradiology 4/2021

24.01.2021 | Original Article

Torsional Characterization of Braided Flow Diverter Stents

A New Method to Evaluate Twisting Phenomenon

verfasst von: Prasanth Velvaluri, Johannes Hensler, Fritz Wodarg, Olav Jansen, Eckhard Quandt

Erschienen in: Clinical Neuroradiology | Ausgabe 4/2021

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Abstract

Purpose

In the interventional treatment of cerebral aneurysms, flow diverter (FD) stents have played a significant role for more than a decade. Many studies have shown good aneurysm occlusion rates and low complication profiles. However, feared complications include acute thrombotic vessel occlusion due to stenotic deformation of the FD during release, the so-called twisting. This work investigates the behavior of different stent types to causative torsion forces in a mechanical model.

Materials and Methods

Torsion characterization equipment was custom built, and two different FD stents (Derivo, Acandis and P64, Phenox) with n = 3 were tested. One end of the FD was fixed while the other end was twisted while measuring the torsion force.

Results

In torsional force vs. the twisting angle graph, a very sharp decrease and increase in force was recorded when the stent collapsed or reopened, respectively, making it possible to characterize for twisting. All six devices showed partial/complete collapse on torsion and showed significant delayed reopening on untwisting. Interestingly on repeated testing, the stent collapsed at earlier angles, probably due to microscopic material defects. Slight variations between stents of the same type suggest that more extensive data sets are needed.

Conclusions

We report a new method to characterize torsion for braided FD stents, which is reliable and reproducible. Additionally, the delayed reopening and the tendency to collapse at earlier angles on consequent testing maneuvers can be significant for clinical usage.
Literatur
1.
Zurück zum Zitat Cagnazzo F, Mantilla D, Lefevre PH, Dargazanli C, Gascou G, Costalat V. Treatment of Middle Cerebral Artery Aneurysms with Flow-Diverter Stents: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2017;38:2289–94.CrossRefPubMedPubMedCentral Cagnazzo F, Mantilla D, Lefevre PH, Dargazanli C, Gascou G, Costalat V. Treatment of Middle Cerebral Artery Aneurysms with Flow-Diverter Stents: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2017;38:2289–94.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Sadasivan C, Cesar L, Seong J, Rakian A, Hao Q, Tio FO, Wakhloo AK, Lieber BB. An original flow diversion device for the treatment of intracranial aneurysms: evaluation in the rabbit elastase-induced model. Stroke. 2009;40:952–8.CrossRef Sadasivan C, Cesar L, Seong J, Rakian A, Hao Q, Tio FO, Wakhloo AK, Lieber BB. An original flow diversion device for the treatment of intracranial aneurysms: evaluation in the rabbit elastase-induced model. Stroke. 2009;40:952–8.CrossRef
3.
Zurück zum Zitat Briganti F, Leone G, Ugga L, Marseglia M, Macera A, Manto A, Delehaye L, Resta M, Resta M, Burdi N, Nuzzi NP, Divenuto I, Caranci F, Muto M, Solari D, Cappabianca P, Maiuri F. Mid-term and long-term follow-up of intracranial aneurysms treated by the p64 Flow Modulation Device: a multicenter experience. J Neurointerv Surg. 2017;9:70–6.CrossRef Briganti F, Leone G, Ugga L, Marseglia M, Macera A, Manto A, Delehaye L, Resta M, Resta M, Burdi N, Nuzzi NP, Divenuto I, Caranci F, Muto M, Solari D, Cappabianca P, Maiuri F. Mid-term and long-term follow-up of intracranial aneurysms treated by the p64 Flow Modulation Device: a multicenter experience. J Neurointerv Surg. 2017;9:70–6.CrossRef
4.
Zurück zum Zitat Kraus B, Goertz L, Turowski B, Borggrefe J, Schlamann M, Dorn F, Kabbasch C. Safety and efficacy of the Derivo Embolization Device for the treatment of unruptured intracranial aneurysms: a multicentric study. J Neurointerv Surg. 2019;11:68–73.CrossRef Kraus B, Goertz L, Turowski B, Borggrefe J, Schlamann M, Dorn F, Kabbasch C. Safety and efficacy of the Derivo Embolization Device for the treatment of unruptured intracranial aneurysms: a multicentric study. J Neurointerv Surg. 2019;11:68–73.CrossRef
5.
Zurück zum Zitat Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonafé A, Cekirge S, Fiorella D, Jabbour P, Levy E, McDougall C, Siddiqui A, Szikora I, Woo H, Albuquerque F, Bozorgchami H, Dashti SR, Delgado Almandoz JE, Kelly ME, Turner R 4th, Woodward BK, Brinjikji W, Lanzino G, Lylyk P. International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study. AJNR Am J Neuroradiol. 2015;36:108–15. Erratum in: AJNR Am J Neuroradiol. 2015;36:E39–40.CrossRef Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonafé A, Cekirge S, Fiorella D, Jabbour P, Levy E, McDougall C, Siddiqui A, Szikora I, Woo H, Albuquerque F, Bozorgchami H, Dashti SR, Delgado Almandoz JE, Kelly ME, Turner R 4th, Woodward BK, Brinjikji W, Lanzino G, Lylyk P. International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study. AJNR Am J Neuroradiol. 2015;36:108–15. Erratum in: AJNR Am J Neuroradiol. 2015;36:E39–40.CrossRef
6.
Zurück zum Zitat Shankar JJ, Tampieri D, Iancu D, Cortes M, Agid R, Krings T, Wong J, Lavoie P, Ghostine J, Shettar B, Ritchie K, Weill A. SILK flow diverter for complex intracranial aneurysms: a Canadian registry. J Neurointerv Surg. 2016;8:273–8.CrossRef Shankar JJ, Tampieri D, Iancu D, Cortes M, Agid R, Krings T, Wong J, Lavoie P, Ghostine J, Shettar B, Ritchie K, Weill A. SILK flow diverter for complex intracranial aneurysms: a Canadian registry. J Neurointerv Surg. 2016;8:273–8.CrossRef
7.
Zurück zum Zitat Maragkos GA, Dmytriw AA, Salem MM, Tutino VM, Meng H, Cognard C, Machi P, Krings T, Mendes Pereira V. Overview of Different Flow Diverters and Flow Dynamics. Neurosurgery. 2020;86(Suppl 1):S21–34.CrossRef Maragkos GA, Dmytriw AA, Salem MM, Tutino VM, Meng H, Cognard C, Machi P, Krings T, Mendes Pereira V. Overview of Different Flow Diverters and Flow Dynamics. Neurosurgery. 2020;86(Suppl 1):S21–34.CrossRef
8.
Zurück zum Zitat Chalouhi N, Tjoumakaris SI, Gonzalez LF, Hasan D, Pema PJ, Gould G, Rosenwasser RH, Jabbour PM. Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases. AJNR Am J Neuroradiol. 2013;34:2326–30.CrossRef Chalouhi N, Tjoumakaris SI, Gonzalez LF, Hasan D, Pema PJ, Gould G, Rosenwasser RH, Jabbour PM. Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases. AJNR Am J Neuroradiol. 2013;34:2326–30.CrossRef
9.
Zurück zum Zitat Zhou G, Su M, Yin YL, Li MH. Complications associated with the use of flow-diverting devices for cerebral aneurysms: a systematic review and meta-analysis. Neurosurg Focus. 2017;42:E17.CrossRef Zhou G, Su M, Yin YL, Li MH. Complications associated with the use of flow-diverting devices for cerebral aneurysms: a systematic review and meta-analysis. Neurosurg Focus. 2017;42:E17.CrossRef
10.
Zurück zum Zitat Cho SH, Jo WI, Jo YE, Yang KH, Park JC, Lee DH. Bench-top Comparison of Physical Properties of 4 Commercially-Available Self-Expanding Intracranial Stents. Neurointervention. 2017;12:31–9.CrossRef Cho SH, Jo WI, Jo YE, Yang KH, Park JC, Lee DH. Bench-top Comparison of Physical Properties of 4 Commercially-Available Self-Expanding Intracranial Stents. Neurointervention. 2017;12:31–9.CrossRef
11.
Zurück zum Zitat Krischek Ö, Miloslavski E, Fischer S, Shrivastava S, Henkes H. A comparison of functional and physical properties of self-expanding intracranial stents [Neuroform3, Wingspan, Solitaire, Leo+, Enterprise]. Minim Invasive Neurosurg. 2011;54:21–8.CrossRef Krischek Ö, Miloslavski E, Fischer S, Shrivastava S, Henkes H. A comparison of functional and physical properties of self-expanding intracranial stents [Neuroform3, Wingspan, Solitaire, Leo+, Enterprise]. Minim Invasive Neurosurg. 2011;54:21–8.CrossRef
Metadaten
Titel
Torsional Characterization of Braided Flow Diverter Stents
A New Method to Evaluate Twisting Phenomenon
verfasst von
Prasanth Velvaluri
Johannes Hensler
Fritz Wodarg
Olav Jansen
Eckhard Quandt
Publikationsdatum
24.01.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Neuroradiology / Ausgabe 4/2021
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-020-00991-2

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