Research Study: Rapid Quantification of Aneurysm Flow and Device-Induced Flow Changes for Real-Time Analysis during Treatment
Primary Investigator: Aichi Chien, PhD (Assistant Professor of Radiological Sciences at UCLA)
Co-Investigators: Fernando Viñuela, MD (Director of the Rigler Radiology Animal Research Center, Professor of Radiology at UCLA), Gary R. Duckwiler, MD (Professor of Radiology at UCLA, Director of Interventional Neuroradiology)
Background: Aneurysms that occur in certain locations are difficult to treat by surgical clipping and large and wide-neck aneurysms cannot be completely occluded with endovascular coils. Recently a new type of interventional device–the flow-diverting stent (FDS)–was introduced to help prevent aneurysm rupture. However, clinical results have shown considerable variation in FDS treatment outcome as well as procedure-related complications. It is currently unclear why FDS treatment is effective in some cases and not in others. There is a powerful need to understand why these complications occur and improve patient selection to reduce complication rates. Assessing how these devices achieve this goal requires studying information related to aneurysm blood flow.
Research Objective: The objective of this project is to develop a quantitative tool to measure aneurysm blood flow which works directly with routinely-collected 2D digital subtraction angiography (DSA) images. The central hypothesis of this project is that quantitative aneurysm flow measurements can be relevant to FDS treatment selection and outcome.
Outcomes: Developing a quantitative tool to measure injected contrast agent flow, we expect to extract a wealth of blood flow dynamic information, allowing us to study flow-related risk properties, specifically, aneurysm flow impingement, pulsatility, pressure, and flow reduction provided by treatment. This quantitative flow measurement tool will provide physicians with currently inaccessible, objective, and reproducible flow information with which to make informed treatment decisions.
These findings may be immediately relevant to clinical treatment of aneurysms, by explaining flow mechanisms underlying FDS outcome and complications. This may lead to decreased FDS treatment related complications by encouraging certain types of aneurysms to be excluded from FDS treatment.
In the future, this method will be applied to study or develop new aneurysm treatment devices and will facilitate very large scale, multi-center aneurysm research. The eventual availability of real-time flow information during treatment will further improve device deployment, reducing patient mortality, the occurrence of stroke, and other complications.
