Comparison of two stents in modifying cerebral aneurysm hemodynamics

Ann Biomed Eng. 2008 May;36(5):726-41. doi: 10.1007/s10439-008-9449-4. Epub 2008 Feb 9.

Abstract

There is a general lack of quantitative understanding about how specific design features of endovascular stents (struts and mesh design, porosity) affect the hemodynamics in intracranial aneurysms. To shed light on this issue, we studied two commercial high-porosity stents (Tristar stent and Wallstent) in aneurysm models of varying vessel curvature as well as in a patient-specific model using Computational Fluid Dynamics. We investigated how these stents modify hemodynamic parameters such as aneurysmal inflow rate, stasis, and wall shear stress, and how such changes are related to the specific designs. We found that the flow damping effect of stents and resulting aneurysmal stasis and wall shear stress are strongly influenced by stent porosity, strut design, and mesh hole shape. We also confirmed that the damping effect is significantly reduced at higher vessel curvatures, which indicates limited usefulness of high-porosity stents as a stand-alone treatment. Finally, we showed that the stasis-inducing performance of stents in 3D geometries can be predicted from the hydraulic resistance of their flat mesh screens. From this, we propose a methodology to cost-effectively compare different stent designs before running a full 3D simulation.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Blood Flow Velocity*
  • Blood Pressure*
  • Blood Vessel Prosthesis*
  • Cerebral Arteries / physiopathology*
  • Cerebral Arteries / surgery*
  • Computer Simulation
  • Equipment Failure Analysis
  • Humans
  • Intracranial Aneurysm / physiopathology*
  • Intracranial Aneurysm / surgery*
  • Models, Cardiovascular*
  • Prosthesis Design
  • Surgery, Computer-Assisted / methods
  • Treatment Outcome