E-036 New in vitro AVM model with realistic nidus for simulation and flow analysis

Background In vitro vascular models for brain aneurysms and acute stroke have been used for training, simulation and research purpose. However, the use of realistic in vitro models for arteriovenous malformation (AVM) have not been reported. Current in vitro AVM models analyzing the efficacy of embolic materials or flow conditions are limited due to a lack of realistic anatomical and dynamic features of complex nidus. Materials and Methods 3D AVM nidus images were extracted and segmented from 3D rotational angiography from a patient. Additional artificial feeders and drainers were attached to the AVM nidus. The inner vascular mold was printed using a plastic 3D printer. The inner mold was coated with silicone and then removed with acetone, leaving a hollow AVM model. Injections of liuid embolic material and 4D flow MRI were performed using the 3D in vitro AVM model. Computational fluid dynamics (CFD) analysis was also performed to compare the flow volume and velocity to 4D flow MRI Results The created in vitro AVM models had realistic representation of nidus vasculature and complexity derived from patients. The injection of liquid embolic material performed in this model replicated real-life treatment conditions. The plug and push technique was successfully simulated to penetratreliquid embolic material into the AVM nidus. The flow data from 4D flow MRI were comparable to CFD analysis. Conclusions An in vitro human brain AVM model with realistic complexities of nidus was successfully manufactured using 3D printing technology. The model demonstrated realistic pliability during the liquid embolic material injection and also feasibility of flow analysis. This in vitro AVM model may represent a valuable tool for simulation, flow research and development of new materials or technique. Disclosures N. Kaneko: None. H. Ullman: None. F. Ali: None. P. Berg: 1; C; German Research Foundation, Federal Ministry of Education and Research within the Forschungscampus STIMULATE. Y. Ooi: None. S. Tateshima: 2; C; Cerenovus, Medtronic, Stryker. G. Colby: 2; C; Medtronic, Microvention, Stryker. Y. Komuro: None. P. Hu: None. V. Szeder: None. M. Nour: None. L. Guo: None. A. Chien: None. F. Vinuela: None. S. Nemoto: None. J. Hinman: None. G. Duckwiler: 1; C; Tarsadia Foundation. 2; C; Medtronic. R. Jahan: None.