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Neuroradiology

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01-05-2013 | Interventional Neuroradiology

Biodegradable flow-diverting device for the treatment of intracranial aneurysm: short-term results of a rabbit experiment

Authors: Kuizhong Wang, Shaoji Yuan, Xuping Zhang, Qiang Liu, Qisheng Zhong, Rongwei Zhang, Peigang Lu, Jiwen Li

Published in: Neuroradiology | Issue 5/2013

Abstract

Introduction

One main complication of a flow-diverting device (FD) in treating intracranial aneurysm is stenosis of parent artery (PA) or occlusion of side branches. The use of a biodegradable device may satisfy the need for aneurysm occlusion and eliminate potential complications.

Methods

Twenty elastase-induced aneurysm rabbit models were divided into three groups: in group 1 (n = 7), polyglycolic acid FDs (PGA-FDs) were implanted across the necks of aneurysms and the abdominal aortas (AA), covering the ostium of a lumbar artery; in group 2 (n = 7), the PGA-FDs were replaced by metal FDs; and in group 3 (n = 6), the PGA-FDs were only implanted across the necks of aneurysms. Animals in group 3 underwent angiography at 6 weeks; those in groups 1 and 2 underwent angiography at 3 months. The status of aneurysm embolization and patency of side branches were assessed.

Results

Complete aneurysm occlusion rates in groups 1 and 3 were 83.3 and 66.7 %, respectively, compared with 0 % in group 2. No side branch occlusions were noted. PA neointimal hyperplasia was minimal, and there were no significant differences between groups 1 and 2 (P = 0.233). The neointimal coverage ratio of the branch ostium in AA in group 1 was not significantly different from that in group 2 (P = 0.605). The neointima comprised predominantly smooth muscle cells and collagen fibers.

Conclusions

The PGA-FD was an effective device for the treatment of aneurysms and was safe for side branches at the 3-month follow-up.

Sadasivan C, Cesar L, Seong J et al (2009) An original flow diversion device for the treatment of intracranial aneurysms: evaluation in the rabbit elastase-induced model. Stroke 40:952–958PubMedCrossRef

Fischer S, Vajda Z, Aguilar Perez M et al (2012) Pipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. Neuroradiology 54:369–382PubMedCrossRef

Lubicz B, Collignon L, Raphaeli G et al (2010) Flow-diverter stent for the endovascular treatment of intracranial aneurysms: a prospective study in 29 patients with 34 aneurysms. Stroke 41:2247–2253PubMedCrossRef

van Rooij WJ, Sluzewski M (2010) Perforator infarction after placement of a pipeline flow-diverting stent for an unruptured A1 aneurysm. AJNR Am J Neuroradiol 31:E43–E44PubMedCrossRef

Fiorella D, Hsu D, Woo HH et al (2010) Very late thrombosis of a pipeline embolization device construct: case report. Neurosurgery 67:onsE313–onsE314PubMedCrossRef

Hong B, Wang K, Huang Q et al (2012) Effects of metal coverage rate of flow diversion device on neointimal growth at side branch ostium and stented artery: an animal experiment in rabbit abdominal aorta. Neuroradiology 54:849–855PubMedCrossRef

Hofma SH, Whelan DM, van Beusekom HM et al (1998) Increasing arterial wall injury after long-term implantation of two types of stent in a porcine coronary model. Eur Heart J 19:601–609PubMedCrossRef

Hutmacher D, Hürzeler MB, Schliephake H (1996) A review of material properties of biodegradable and bioresorbable polymers and devices for GTR and GBR applications. Int J Oral Maxillofac Implants 11:667–678PubMed

Nishio S, Kosuga K, Igaki K et al (2012) Long-term (>10 years) clinical outcomes of first-in-human biodegradable poly-l-lactic acid coronary stents: Igaki–Tamai stents. Circulation 125:2343–2353PubMedCrossRef

10.

Wang K, Huang Q, Hong B et al (2009) Neck injury is critical to elastase-induced aneurysm model. AJNR Am J Neuroradiol 30:1685–1687PubMedCrossRef

11.

Kallmes DF, Ding YH, Dai D et al (2007) A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke 38:2346–2352PubMedCrossRef

12.

Kallmes DF, Ding YH, Dai D et al (2009) A second-generation, endoluminal, flow-disrupting device for treatment of saccular aneurysms. AJNR Am J Neuroradiol 30:1153–1158PubMedCrossRef

13.

Kamran M, Yarnold J, Grunwald IQ et al (2011) Assessment of angiographic outcomes after flow diversion treatment of intracranial aneurysms: a new grading schema. Neuroradiology 53:501–508PubMedCrossRef

14.

Wang K, Huang Q, Hong B et al (2012) Correlation of aneurysms occlusion with actual metal coverage at neck after flow-diverting stent implanted in rabbit models. Neuroradiology 54:607–613PubMedCrossRef

15.

Lieber BB, Sadasivan C (2010) Endoluminal scaffolds for vascular reconstruction and exclusion of aneurysms from the cerebral circulation. Stroke 41:S21–S25PubMedCrossRef

16.

Zilberman M, Nelson KD, Eberhart RC (2005) Mechanical properties and in vitro degradation of bioresorbable fibers and expandable fiber-based stents. J Biomed Mater Res B Appl Biomater 74:792–799PubMed

17.

Zamiri P, Kuang Y, Sharma U et al (2010) The biocompatibility of rapidly degrading polymeric stents in porcine carotid arteries. Biomaterials 31:7847–7855PubMedCrossRef

18.

Komatsu R, Ueda M, Naruko T et al (1998) Neointimal tissue response at sites of coronary stenting in humans: macroscopic, histological, and immunohistochemical analyses. Circulation 98:224–233PubMedCrossRef

19.

Yokota T, Ichikawa H, Matsumiya G et al (2008) In situ tissue regeneration using a novel tissue-engineered, small-caliber vascular graft without cell seeding. J Thorac Cardiovasc Surg 136:900–907PubMedCrossRef

20.

Padfield GJ, Newby DE, Mills NL (2010) Understanding the role of endothelial progenitor cells in percutaneous coronary intervention. J Am Coll Cardiol 55:1553–1565PubMedCrossRef

21.

Takahashi H, Yokota T, Uchimura E et al (2009) Newly developed tissue-engineered material for reconstruction of vascular wall without cell seeding. Ann Thorac Surg 88:1269–1276PubMedCrossRef

Title: Biodegradable flow-diverting device for the treatment of intracranial aneurysm: short-term results of a rabbit experiment
Authors: Kuizhong Wang
Shaoji Yuan
Xuping Zhang
Qiang Liu
Qisheng Zhong
Rongwei Zhang
Peigang Lu
Jiwen Li
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 5/2013
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-013-1150-0

At a glance: The STEP trials

Springer Medicine

Biodegradable flow-diverting device for the treatment of intracranial aneurysm: short-term results of a rabbit experiment

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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