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Angiología

On-line version ISSN 1695-2987Print version ISSN 0003-3170

Abstract

SANCHEZ NEVAREZ, Manuel Ignacio; PLANA ANDANI, Emma  and  MIRALLES HERNANDEZ, Manuel. Hemodynamic impact analysis of mesh-type embolic protection devices in an in vitro model. Angiología [online]. 2020, vol.72, n.4, pp.178-185.  Epub Dec 28, 2020. ISSN 1695-2987.  http://dx.doi.org/10.20960/angiologia.00101.

Introduction:

mesh-type embolic protection devices for carotid endovascular procedures (DPEr) are commonly used, their objective is to reduce the risk of cerebral embolism secondary to plaque manipulation and rupture. Their different characteristics make suspect a different behavior that can affect its effectiveness.

Objective:

to assess the hemodynamic impact caused by DPEr by analyzing their resistance to flow in an in vitro hemodynamic flow model and compare the results between different devices.

Materials and methods:

an in vitro pulsatile flow model with physiological saline serum (SSF) was constructed. Four different DPEr were studied with 5 measurements per device to know the pressure gradient in mmHg and resistance in peripheral resistance units (URP) before and after its deployment. The Wilcoxon signed ranges test and Friedman´s two-way analysis of variance by sample ranges were used. Significant results were considered with a p < 0.05

Results:

60 measurements were made: 10 baselines, 10 with carrier catheter and 40 with unfolded filter. The DPEr1 presented the highest resistance (0.88 ± 0.04 URP) significantly higher than the rest (p = 0.041). DPEr4 had a greater resistance to DPEr2 and DPEr3 (0.70 ± 0.02 vs. 0.57 ± 0.08 and 0.57 ± 0.02 URP) although not significant (p = 0.70). No differences were observed between DPEr2 and DPEr3. The symmetrical cone shape was associated with greater resistance (p = 0.002). No differences in the measured parameters were observed depending on the manufacturing material.

Conclusions:

there are differences in DPEr in terms of resistance to flow that depend on their design and porosity. The DPEr with the highest resistance are the DPEr1 and DPEr4 while the DPEr2 offers the least resistance to flow at the expense of its effectiveness.

Keywords : Mesh; Endovascular; Carotid; Model; Hemodynamic.

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