1094 Hemodynamic Effects of an Endovascular Spiral Device in MCA Bifurcation Aneurysms

INTRODUCTION: Endovascular technology has revolutionized the treatment of aneurysms, providing less invasive alternatives to traditional surgery. Despite these advances, significant gaps remain where open surgery is still required, particularly for challenging cases such as large, wide-neck middle cerebral artery (MCA) bifurcation aneurysms. These aneurysms often defy standard endovascular treatment due to their complex anatomy and high flow dynamics, necessitating innovative solutions to bridge this gap. METHODS: A 3D model of an MCA bifurcation aneurysm was sourced from an online database and adapted in Fusion 360 to include a spiral upstream of the aneurysm. FEATool app in MATLAB was used to run fluid simulation to compute pressure and velocity data with and without the spiral device. The data was post-processed in ParaView to get aneurysm head pressures and flow inflow and outflow totals. RESULTS: The introduction of the spiral device resulted in a reduction in aneurysm head pressure in excess of mean arterial pressure from 728 to 366 Pa, a 49.8% decrease. Flow rates into the aneurysm head demonstrated a decrease from 1.37 mL/s to 0.657 mL/s, a 51.9% reduction. These changes suggest a substantial modification in the hemodynamic environment due to the spiral insertion. CONCLUSIONS: The endovascular spiral device shows promise in modifying hemodynamic parameters significantly, suggesting a potential for endovascular management of complex aneurysms. Additionally, the device can be used by itself or in conjunction with existing endovascular treatments due to its position upstream of the aneurysm. However, further simulations incorporating turbulence models and pulsatile flow are needed to fully understand its effectiveness across different aneurysm geometries and conditions.