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Selective Flow Diversion for the Treatment of Intracranial Aneurysms


Flow diverters have generally been successful in the treatment of intracranial aneurysms; however, their utility has been limited by the device’s tendency to divert flow from healthy structures in the vicinity of the lesion site. Here, we show the potential for achieving flow diversion in a selective manner by utilizing an alternative approach in which high aspect-ratio microscale structures are intentionally designed to work congruently with an intermediate porosity flow diverter. We demonstrate this design principle through the realization of a microfabricated flow diverter with finely controlled cross-sectional elements. Using an in vitro basilar trunk model, we demonstrate comparable intra-aneurysmal flow reduction to commercially available flow diverters, while also demonstrating that such devices minimally affect flow into a “jailed” perforating artery (i.e., nearly-eight-fold lower perforator flow reduction than commercial device). This may provide an additional design parameter by which the indication of flow diversion devices may be extended into more delicate structures in the neurovasculature which currently lack a treatment option.

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