Quantifying the effect of IMPEDE-FX packing rate and volume on pressure-normalized principal wall strain in an idealized 3D-printed aneurysm model

Background: This study aimed to quantify the nonbiologic effects of Shape Memory IMPEDE-FX embolization plug deployment rate and packing volume on pressure-normalized wall strain (ερ+¯/PP) of an idealized 3D-printed abdominal aortic aneurysm model. Methods: An endograft was deployed into an abdomina...

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Main Authors: Baqir Kedwai, BHSc, Joshua Geiger, MD, Sam Najjar, BS, Joel Kruger, MD, Michael Richards, PhD, Chung Yeh, BS, Mary Dennehy, BS, Michael Stoner, MD, Doran Mix, MD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:JVS - Vascular Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666350325000082
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Summary:Background: This study aimed to quantify the nonbiologic effects of Shape Memory IMPEDE-FX embolization plug deployment rate and packing volume on pressure-normalized wall strain (ερ+¯/PP) of an idealized 3D-printed abdominal aortic aneurysm model. Methods: An endograft was deployed into an abdominal aortic aneurysm model and connected to an industry-validated hemodynamic simulator. Plugs were deployed into the excluded sac to packing volumes of 100%, 200%, 300%, and 400% under two conditions: (1) sequential and (2) immediate deployment. Axial ultrasound images were taken for each packing volume. Frame-to-frame displacements of the aneurysm wall were measured with ultrasound elastography over one cardiac cycle and normalized to the circuit's pulse pressure to calculate the mean principal strain (ερ+¯/PP). Results: In the 100% packing condition, ερ+¯/PP was +113% above baseline at 15 minutes. After sequential deployment to 400%, the ερ+¯/PP trended down to +43% above baseline. Immediate packing was associated with a greater ερ+¯/PP reduction than sequential packing. When packed immediately to 400%, the ερ+¯/PP was −6.7% below baseline. Conclusions: These modeling data suggest that an immediate deployment strategy and higher plug packing volumes are associated with lower ερ+¯/PP, which has been associated with decreased sac growth rates. Clinical Relevance: The present findings suggest that rapid, high-volume filling of IMPEDE-FX embolization plugs results in a reduction in wall ερ+¯/PP, independent of thrombus formation. Fully expanded embolization plugs in aggregate limit pulsatile aortic sac displacement likely contribute to a greater reduction in overall wall strain compared with low packing volumes. These findings may inform clinical application for this device, supporting a rapid and high-volume deployment strategy for greater reduction in ερ+¯/PP status post endovascular aneurysm repair.
ISSN:2666-3503