Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular Model

Introduction Intracranial atherosclerotic disease (ICAD) induces the luminal narrowing of an intracranial vessel and represents one of the major causes of ischemic strokes [1, 2, 3, 4]. In vitro 3D printed models have gained popularity in the stroke research field as they are morphologically accurat...

Full description

Saved in:
Bibliographic Details
Main Authors: Riccardo Daniel Tiberi, Jiahui Li, Joan Vargas, Magda Jablonska, Judith Cendrero, Pere Canals, Marc Molina, Alejandro Tomasello, Marc Ribo
Format: Article
Language:English
Published: Wiley 2023-11-01
Series:Stroke: Vascular and Interventional Neurology
Online Access:https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.191
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850152053072986112
author Riccardo Daniel Tiberi
Jiahui Li
Joan Vargas
Magda Jablonska
Judith Cendrero
Pere Canals
Marc Molina
Alejandro Tomasello
Marc Ribo
author_facet Riccardo Daniel Tiberi
Jiahui Li
Joan Vargas
Magda Jablonska
Judith Cendrero
Pere Canals
Marc Molina
Alejandro Tomasello
Marc Ribo
author_sort Riccardo Daniel Tiberi
collection DOAJ
description Introduction Intracranial atherosclerotic disease (ICAD) induces the luminal narrowing of an intracranial vessel and represents one of the major causes of ischemic strokes [1, 2, 3, 4]. In vitro 3D printed models have gained popularity in the stroke research field as they are morphologically accurate and offer the possibility to simulate clinical scenarios for training purposes or device testing. Despite being a challenge for interventionalists, to date, clinically accurate ICAD in vitro models have not been developed. We aimed to develop a 3D printed ICAD model including realistic features to provide an optimal simulation phantom for research and training purposes. Methods Stereolithography 3D printing technique was used to create a resin neurovascular model based on vascular anatomies extracted from anonymized CTA images. The phantom includes the aortic arch, all supraoptic cervical arteries and a complete circle of Willis up to the M2‐MCA, A2‐ACA and P2‐PCA segments. 3% sodium alginate solution was cast into a stenosis mold and crosslinked in a 40% calcium chloride. The deformable gel constituted an 8mm long replaceable stenotic segment at the level of M1‐MCA simulating an atherosclerotic plaque with a 0.5mm internal diameter. A flow sensor (ME‐8PXL, Transonic) was used to measure the lesion flow rate before and after endovascular treatment was performed under fluoroscopy. Results The baseline angiographic run showed an irregular 80% stenosis at the level of M1‐MCA that generated a substantial delay of contrast arrival to the distal branches. After angioplasty (Gateway PTA Balloon Catheter 3.5x20mm, Boston Scientific) and stenting (Wingspan 2.5mmx15mm, Stryker) were performed the residual stenosis was <10% (Figure 1). An initial stenosis flow rate was registered with a value of 8.5 ± 5.33 mL/min. Following the completion of the endovascular procedure, the flow sensor detected a post‐procedural stenosis flow rate of 160 ± 3.45 mL/min. Conclusion The developed ICAD model is anatomically accurate and offers realistic physiological and procedural features. The phantom represents an ideal tool for training purposes and a platform to test different devices for the endovascular treatment of ICAD. The methodology and materials could be applied to simulate stenotic lesions at different levels in the cervical and intracranial arteries.
format Article
id doaj-art-45f50a38b59e45f8bd16cfaa17238cdc
institution OA Journals
issn 2694-5746
language English
publishDate 2023-11-01
publisher Wiley
record_format Article
series Stroke: Vascular and Interventional Neurology
spelling doaj-art-45f50a38b59e45f8bd16cfaa17238cdc2025-08-20T02:26:04ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-11-013S210.1161/SVIN.03.suppl_2.191Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular ModelRiccardo Daniel Tiberi0Jiahui Li1Joan Vargas2Magda Jablonska3Judith Cendrero4Pere Canals5Marc Molina6Alejandro Tomasello7Marc Ribo8Vall d'Hebron Institut de Recerca Barcelona SpainVall d'Hebron Institut de Recerca Barcelona SpainVall d'Hebron University Hospital Barcelona SpainVall d'Hebron Institut de Recerca Barcelona SpainVall d'Hebron Institut de Recerca Barcelona SpainVall d'Hebron Institut de Recerca Barcelona SpainVall d'Hebron Institut de Recerca Barcelona SpainVall d'Hebron University Hospital Barcelona SpainVall d'Hebron Institut de Recerca Barcelona SpainIntroduction Intracranial atherosclerotic disease (ICAD) induces the luminal narrowing of an intracranial vessel and represents one of the major causes of ischemic strokes [1, 2, 3, 4]. In vitro 3D printed models have gained popularity in the stroke research field as they are morphologically accurate and offer the possibility to simulate clinical scenarios for training purposes or device testing. Despite being a challenge for interventionalists, to date, clinically accurate ICAD in vitro models have not been developed. We aimed to develop a 3D printed ICAD model including realistic features to provide an optimal simulation phantom for research and training purposes. Methods Stereolithography 3D printing technique was used to create a resin neurovascular model based on vascular anatomies extracted from anonymized CTA images. The phantom includes the aortic arch, all supraoptic cervical arteries and a complete circle of Willis up to the M2‐MCA, A2‐ACA and P2‐PCA segments. 3% sodium alginate solution was cast into a stenosis mold and crosslinked in a 40% calcium chloride. The deformable gel constituted an 8mm long replaceable stenotic segment at the level of M1‐MCA simulating an atherosclerotic plaque with a 0.5mm internal diameter. A flow sensor (ME‐8PXL, Transonic) was used to measure the lesion flow rate before and after endovascular treatment was performed under fluoroscopy. Results The baseline angiographic run showed an irregular 80% stenosis at the level of M1‐MCA that generated a substantial delay of contrast arrival to the distal branches. After angioplasty (Gateway PTA Balloon Catheter 3.5x20mm, Boston Scientific) and stenting (Wingspan 2.5mmx15mm, Stryker) were performed the residual stenosis was <10% (Figure 1). An initial stenosis flow rate was registered with a value of 8.5 ± 5.33 mL/min. Following the completion of the endovascular procedure, the flow sensor detected a post‐procedural stenosis flow rate of 160 ± 3.45 mL/min. Conclusion The developed ICAD model is anatomically accurate and offers realistic physiological and procedural features. The phantom represents an ideal tool for training purposes and a platform to test different devices for the endovascular treatment of ICAD. The methodology and materials could be applied to simulate stenotic lesions at different levels in the cervical and intracranial arteries.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.191
spellingShingle Riccardo Daniel Tiberi
Jiahui Li
Joan Vargas
Magda Jablonska
Judith Cendrero
Pere Canals
Marc Molina
Alejandro Tomasello
Marc Ribo
Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular Model
Stroke: Vascular and Interventional Neurology
title Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular Model
title_full Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular Model
title_fullStr Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular Model
title_full_unstemmed Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular Model
title_short Abstract 191: Simulating Intracranial Stenosis: A Methodological Approach In An In‐Vitro Neurovascular Model
title_sort abstract 191 simulating intracranial stenosis a methodological approach in an in vitro neurovascular model
url https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.191
work_keys_str_mv AT riccardodanieltiberi abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT jiahuili abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT joanvargas abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT magdajablonska abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT judithcendrero abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT perecanals abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT marcmolina abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT alejandrotomasello abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel
AT marcribo abstract191simulatingintracranialstenosisamethodologicalapproachinaninvitroneurovascularmodel