Evidence map›Paper›PMID 39789382›Full record

ArticleActa neurochirurgica2025

Aneurysm dome and vessel pressure measurements with coiling, stent assisted coiling and flow diversion.

Timothy A Becker, Kailey L Lewis, Holly F Berns, Sophia E Robertson, Wyatt E Clark, Jesse C Wells, Mohammed K Alnajrani, Christopher Rapoport, Patrick Barhouse, Felipe Ramirez-Velandia and 5 more

Abstract read
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In one paragraph

Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Timothy A BeckerMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Kailey L LewisMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Holly F BernsMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Sophia E RobertsonMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Wyatt E ClarkMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Jesse C WellsMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Mohammed K AlnajraniMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Christopher RapoportMechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, USA.
Patrick BarhouseDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Felipe Ramirez-VelandiaDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Jean FiloDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Michael YoungDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Sandeep MuramDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Justin H GransteinDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Christopher S OgilvyDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA. cogilvy@bidmc.harvard.edu.

Funding

Brain Aneurysm Foundation 2022 and 2023 award
6 · The paper itself

Abstract

backgroundVariability in long-term endovascular treatment outcomes for intracranial aneurysms has prompted questions regarding the effects of these treatments on aneurysm hemodynamics. Endovascular techniques disrupt aneurysmal blood flow and shear, but their influence on intra-aneurysmal pressure remains unclear. A better understanding of aneurysm pressure effects may aid in predicting outcomes and guiding treatment decisions.

methodsMedium and large aneurysm models with intramural pressure taps on the dome and parent artery were designed and 3D-printed with vessel-like physical properties from UV-cured materials. The models were connected to a comprehensive flow system consisting of a pulsatile pump and a viscosity-matched blood analog. The system provided physiological pressure and flow control. Real-time pressures were recorded in the aneurysm dome and parent artery during initial placement of coils, stents, flow diverters, and temporary balloons under simulated surgical conditions. Coiling, stent-assisted coiling, and flow diverter placement were performed in both aneurysm sizes. Temporary balloon placement was performed in a large aneurysm model.

resultsCoiling resulted in 24-30% packing density and diminished intra-aneurysmal flow. Flow diverter placement reduced intra-aneurysmal flow with near complete flow interruption after placement of three consecutive devices across the aneurysm neck. Compared to untreated controls, real-time pressure measurements during coiling and flow diversion showed minimal changes (< 5%) in intra-aneurysmal pressures. Temporary balloon occlusion blocked the parent artery, increasing the pressure proximal to the site of occlusion (by 9%), and reducing the pressure distally (by 14%). This maneuver also dampened intra-aneurysmal pressure to the average distal vessel pressure measurement. Positive control aneurysm models were 3D-printed with a sealed, "healed" neck. These controls verified a sealed neck eliminates intra-aneurysmal pressure.

conclusionFindings quantified minimal changes in intra-aneurysmal pressure during and immediately post-coiling and flow diversion. Intra-aneurysmal flow disruption alone has negligible impact on intra-aneurysmal pressures.

Indexed as

Endovascular ProceduresIntracranial AneurysmStentsCerebrovascular CirculationEmbolization, TherapeuticHemodynamicsHumansPrinting, Three-DimensionalCoilingFlowFlow diversionIntracranial aneurysmOcclusionPressureStent

Identifiers

PMID39789382

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.