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Peer-reviewedCC BY 4.0Journal of the Royal Society Interface

Gravity-driven flow for intracranial saccular aneurysm filling

  • Tirosh Mekler1
  • Maria Khoury1
  • Yevgeniy Kreinin1
  • Rami Fishler1
  • Nir Natan1
  • Ron Bessler1
  • Alexander Leshansky2
  • Josué Sznitman1
  • Netanel Korin1,3
  1. 1Department of Biomedical Engineering, Technion—Israel Institute of Technology, Haifa, Israel
  2. 2Department of Chemical Engineering, Technion—Israel Institute of Technology, Haifa, Israel
  3. 3Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA
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Abstract

Intracranial aneurysms (IAs) are life-threatening cerebrovascular malformations in which complete and durable sac closure is the primary goal of endovascular treatments, including coiling, stent-assisted coiling and flow-diverter implantation. However, standard catheter-based approaches may fail to fully occlude the sac and are limited by the need for direct access. Liquid embolic agents offer better geometric conformity, but their deployment remains constrained by similar access issues. In this study, we present a gravity-driven approach for distal filling of IAs. Through a combination of analytical modelling, in vitro experiments with idealized aneurysm models, and patient-specific computational fluid dynamics (CFD) simulations, we demonstrate that efficient filling of aneurysm cavities from relatively remote locations may be achieved using a heavier injectable fluid, while properly adjusting tilt angle and injection flow rate. A phase diagram of flow regimes highlights the interplay between gravitational, inertial and viscous forces critical to successful filling. Our findings show that slow, gravity-assisted injections minimize bypass and spillover, enabling targeted aneurysm filling even in complex geometries. CFD simulations highlight the need for patient-specific planning of such a procedure accounting for personal vascular anatomy. This strategy may provide a safer and less invasive alternative to current endovascular techniques, especially for anatomically inaccessible aneurysms.

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Cite

BibTeXRIS
BibTeX
@article{mekler2026gravitydriven,
  title = {{Gravity-driven flow for intracranial saccular aneurysm filling}},
  author = {Tirosh Mekler and Maria Khoury and Yevgeniy Kreinin and Rami Fishler and Nir Natan and Ron Bessler and Alexander Leshansky and Josué Sznitman and Netanel Korin},
  journal = {Journal of the Royal Society Interface},
  year = {2026},
  month = oct,
  doi = {10.1098/rsif.2025.0968},
  url = {https://doi.org/10.1098/rsif.2025.0968},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Gravity-driven flow for intracranial saccular aneurysm filling
AU  - Tirosh Mekler
AU  - Maria Khoury
AU  - Yevgeniy Kreinin
AU  - Rami Fishler
AU  - Nir Natan
AU  - Ron Bessler
AU  - Alexander Leshansky
AU  - Josué Sznitman
AU  - Netanel Korin
PY  - 2026
DA  - 2026/10/07
JO  - Journal of the Royal Society Interface
DO  - 10.1098/rsif.2025.0968
UR  - https://doi.org/10.1098/rsif.2025.0968
AB  - Intracranial aneurysms (IAs) are life-threatening cerebrovascular malformations in which complete and durable sac closure is the primary goal of endovascular treatments, including coiling, stent-assisted coiling and flow-diverter implantation. However, standard catheter-based approaches may fail to fully occlude the sac and are limited by the need for direct access. Liquid embolic agents offer better geometric conformity, but their deployment remains constrained by similar access issues. In this study, we present a gravity-driven approach for distal filling of IAs. Through a combination of analytical modelling, in vitro experiments with idealized aneurysm models, and patient-specific computational fluid dynamics (CFD) simulations, we demonstrate that efficient filling of aneurysm cavities from relatively remote locations may be achieved using a heavier injectable fluid, while properly adjusting tilt angle and injection flow rate. A phase diagram of flow regimes highlights the interplay between gravitational, inertial and viscous forces critical to successful filling. Our findings show that slow, gravity-assisted injections minimize bypass and spillover, enabling targeted aneurysm filling even in complex geometries. CFD simulations highlight the need for patient-specific planning of such a procedure accounting for personal vascular anatomy. This strategy may provide a safer and less invasive alternative to current endovascular techniques, especially for anatomically inaccessible aneurysms.
SN  - 1742-5689
SN  - 1742-5662
ER  -