Next Generation Flow Diverter for the Treatment of Intracranial Aneurysms

每年有6600名英国公民因颅内动脉瘤（IA）破裂而发生蛛网膜下腔出血（SAH），其中40%死亡，40%严重残疾。然而，通过早期干预，SAH是完全可以避免的。在过去的几十年里，临床干预越来越多地从侵入性、高风险和昂贵的开放手术（夹闭）转向风险更低、成本更低的微创血管内盘绕。在这里线圈被用来填充动脉瘤，防止生长/破裂。然而，对于宽颈动脉瘤，线圈可能会移位并迁移到母动脉中，导致血栓形成和中风的风险。为了解决这个问题，在动脉瘤颈部放置支架。然而，这是昂贵的，疗效有限，并引入了新的风险（血栓形成）。分流器（FDs）是一种新兴的血管内装置（网状结构），它被放置在动脉瘤上以分流血液，从而防止生长/破裂并实现自然愈合。就其性质而言，FD具有有效治疗复杂和宽颈动脉瘤的潜力。然而，现有的fd未能达到预期，报告的性能不如卷绕。FD网格设计固有的局限性是驱动弱且不均匀的径向力，导致不完全开放，血管放置不良，孔隙度和设备锥入可变，并导致不理想的IA闭塞，FD迁移和血栓/中风风险。OE寻求通过开发一种新颖的“折纸灵感”工程FD来克服这些挑战。

Annually 6,600 UK citizens suffer a subarachnoid haemorrhage (SAH) resulting from the rupture of an intracranial aneurysm (IA), of whom 40% will die and 40% will suffer severe disabilities. However, SAH's are entirely avoidable through early intervention.Over the last decades clinical interventions have increasingly moved from invasive, risky, and expensive open surgeries (clipping) to less risky and cheaper minimally invasive endovascular coiling. Here coils are used to fill the aneurysm and prevent growth/rupture. However, for wide necked aneurysms, coils can dislodge and migrate into the parent artery leading to risk of thrombosis and stroke. To address this challenge stents are placed over the aneurysm neck. However, this is expensive, has limited efficacy and introduces new risks (clot formation).Flow diverters (FDs) are an emerging endovascular device (mesh structure) that is placed over the aneurysm to divert blood flow away, thereby prevent growth/rupture and enabling natural healing. By their nature, FD have the potential to effectively treat complex and wide-necked aneurysms.However, existing FDs have failed to live up to expectations, reporting performance inferior to coiling. Limitations are inherent to the FD mesh design that drives weak and non-uniform radial forces, resulting in incomplete opening, poor vessel apposition, variable porosity and device coning, and leading to suboptimal IA occlusion, FD migration and risk of thrombosis/stroke.OE seek to overcome these challenges through development of a novel 'origami inspired' engineered FD.