In-vitro flow assessment study of intra-saccular endovascular devices for brain aneurysm treatment: SEAL™ vs. WEB™

Background Intrasaccular devices such as SEAL™ and WEB™-SL are designed to disrupt aneurysmal flow. We present a new in vitro method for estimating neurointerventional devices’ flow dynamics. Methods Particle image velocimetry (PIV) method was used in a patient-specific middle cerebral artery (MCA) wide-neck bifurcation aneurysm (WNBA) model to measure velocity, residence time (RT), and vorticity strength (VS). Tested devices included 3 each of SEAL-BASE (6 × 2 mm), SEAL-ARC (6 × 5 mm), and WEB-SL (6 × 4 mm). Results Twelve experiments were performed (3 unique devices per size and 3 controls); the mean RT was 0.042 ± 0.006 s (control) and increased with SEAL-BASE (0.387 ± 0.128), SEAL-ARC (0.33 ± 0.092), and WEB-SL (0.171 ± 0.034) (all p  < 0.05 vs. control), and was longer in SEAL-BASE ( p  = 0.046) and SEAL-ARC ( p  = 0.041) than WEB-SL, with no difference between SEAL configurations ( p  = 0.30). The VS decreased from 66.48 ± 8.58 1/s (control) to 14.06 ± 2.80, 13.94 ± 2.53, and 27.60 ± 4.16 for SEAL-BASE, SEAL-ARC, and WEB-SL, respectively. The SEAL devices differed from WEB-SL ( p  = 0.007, 0.006) but not from each other ( p  = 0.52). Velocity magnitude dropped from 109.4 ± 15.5 mm/s (control) to 12.42 ± 3.8, 14.2 ± 3.5, and 25.34 ± 3.16 for SEAL-BASE, SEAL-ARC, and WEB-SL, respectively; greater reductions with SEAL-BASE ( p  = 0.006) and SEAL-ARC ( p  = 0.007) versus WEB-SL, with no difference between the two SEAL configurations ( p  = 0.29). Conclusion Both SEAL configurations achieved greater flow reduction compared to the WEB-SL of similar width in the same aneurysm model. Results highlight the unique utilization of the PIV method for the mechanistic decoupling of momentum transfer into the aneurysm sac resulting from intra-aneurysmal mesh structures and point toward their potential for further neurointerventional device optimization.