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A Finite Element Method to Predict Adverse Events in Intracranial Stenting Using Microstents: In Vitro Verification and Patient Specific Case Study.
Iannaccone, Francesco; De Beule, Matthieu; De Bock, Sander; Van der Bom, Imramsjah M J; Gounis, Matthew J; Wakhloo, Ajay K; Boone, Matthieu; Verhegghe, Benedict; Segers, Patrick.
Afiliación
  • Iannaccone F; IbiTech-bioMMeda, Department of Electronics and Information Systems, iMinds Medical IT, Ghent University, 9000, Ghent, Belgium. francesco.iannaccone@ugent.be.
  • De Beule M; Department of Biomedical Engineering, Thoraxcenter, Erasmus University Medical Center, 3000 CA, Rotterdam, The Netherlands. francesco.iannaccone@ugent.be.
  • De Bock S; IbiTech-bioMMeda, Department of Electronics and Information Systems, iMinds Medical IT, Ghent University, 9000, Ghent, Belgium.
  • Van der Bom IM; FEops bvba, 9000, Ghent, Belgium.
  • Gounis MJ; IbiTech-bioMMeda, Department of Electronics and Information Systems, iMinds Medical IT, Ghent University, 9000, Ghent, Belgium.
  • Wakhloo AK; Image-Guided Therapy Systems, Philips Healthcare, 01810, Andover, MA, USA.
  • Boone M; Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, 01655, Worcester, MA, USA.
  • Verhegghe B; Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, 01655, Worcester, MA, USA.
  • Segers P; Department of Physics and Astronomy, Ghent University Center for X-ray Tomography, 9000, Ghent, Belgium.
Ann Biomed Eng ; 44(2): 442-52, 2016 Feb.
Article en En | MEDLINE | ID: mdl-26620777
Clinical studies have demonstrated the efficacy of stent supported coiling for intra-cranial aneurysm treatment. Despite encouraging outcomes, some matters are yet to be addressed. In particular closed stent designs are influenced by the delivery technique and may suffer from under-expansion, with the typical effect of "hugging" the inner curvature of the vessel which seems related to adverse events. In this study we propose a novel finite element (FE) environment to study potential failure able to reproduce the microcatheter "pull-back" delivery technique. We first verified our procedure with published in vitro data and then replicated the intervention on one patient treated with a 4.5 × 22 mm Enterprise microstent (Codman Neurovascular; Raynham MA, USA). Results showed good agreement with the in vitro test, catching both size and location of the malapposed area. A simulation of a 28 mm stent in the same geometry highlighted the impact of the delivery technique, which leads to larger area of malapposition. The patient specific simulation matched the global stent configuration and zones prone to malapposition shown on the clinical images with difference in tortuosity between actual and virtual treatment around 2.3%. We conclude that the presented FE strategy provides an accurate description of the stent mechanics and, after further in vivo validation and optimization, will be a tool to aid clinicians to anticipate the acute procedural outcome avoiding poor initial results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Falla de Prótesis / Stents / Aneurisma Intracraneal / Bases de Datos Factuales / Análisis de Falla de Equipo Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Ann Biomed Eng Año: 2016 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Falla de Prótesis / Stents / Aneurisma Intracraneal / Bases de Datos Factuales / Análisis de Falla de Equipo Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Ann Biomed Eng Año: 2016 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Estados Unidos