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Treatment of carotid siphon aneurysms by use of the Willis stent graft: an angiographic and histopathological study

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Abstract

Objective

We designed a carotid siphon (CS) aneurysm model in dogs to test a new stent graft (the Willis covered stent) and compared tissue reaction over 12-month follow-up versus a comparison group with stents implanted in straight vessels.

Methods

Twenty-four saccular sidewall aneurysms (group A) and 12 CS aneurysms (group B) were created surgically. A Willis stent graft was implanted in each aneurysm. Angiography was performed immediately and at 1-, 3-, 6- and 12-month post-implantation to investigate aneurysm isolation, endoleak, stent angulation, parent artery (PA) patency and restenosis. Light and scanning electron microscopy were used to identify aneurysmal sac thrombi, intima hyperplasia and endothelial progress.

Results

Immediate angiography demonstrated mild endoleak in two aneurysms and three stent angulations in group B. Follow-up at 12 months revealed resolved endoleaks, occlusion in one PA and mild stenosis in three in group B. In group A, occlusion occurred in one PA and mild stenosis in two. Light microscopy revealed new intima, and all aneurysm sacs were filled with thrombi. In group B, endothelial progress was complete at 12 months, and closely correlated with haemodynamic changes.

Conclusions

Application of a Willis stent graft is a feasible method of treating CS aneurysms, and it exhibits a prolonged endothelial progress compared with that in straight vessels.

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Acknowledgments

This study is supported by the Doctor Innovation Found of Medical School of Shanghai Jiao Tong University (No. BXJ0933).

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Authors and Affiliations

  1. Department of Radiology, The Sixth Affiliated People’s Hospital, Medical School of Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, 200233, China

    Yue-Qi Zhu, Ming-Hua Li, Jian Xie, Hua-Qiao Tan & Jian-Bo Wang

  2. Department of Radiology, The Tenth Affiliated People’s Hospital, Shanghai Tong Ji University, No. 301, Middle Yan Chang Road, Shanghai, 200072, China

    Ying-Sheng Cheng

Authors
  1. Yue-Qi Zhu
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  2. Ming-Hua Li
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  3. Jian Xie
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  4. Hua-Qiao Tan
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  5. Ying-Sheng Cheng
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  6. Jian-Bo Wang
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Corresponding author

Correspondence to Ming-Hua Li.

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Zhu, YQ., Li, MH., Xie, J. et al. Treatment of carotid siphon aneurysms by use of the Willis stent graft: an angiographic and histopathological study. Eur Radiol 20, 1974–1984 (2010). https://doi.org/10.1007/s00330-010-1738-2

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  • DOI: https://doi.org/10.1007/s00330-010-1738-2

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