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.
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References
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 40:952–958
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 54:369–382
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 41:2247–2253
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–E44
Fiorella D, Hsu D, Woo HH et al (2010) Very late thrombosis of a pipeline embolization device construct: case report. Neurosurgery 67:onsE313–onsE314
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 54:849–855
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 19:601–609
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 11:667–678
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 125:2343–2353
Wang K, Huang Q, Hong B et al (2009) Neck injury is critical to elastase-induced aneurysm model. AJNR Am J Neuroradiol 30:1685–1687
Kallmes DF, Ding YH, Dai D et al (2007) A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke 38:2346–2352
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 30:1153–1158
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 53:501–508
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 54:607–613
Lieber BB, Sadasivan C (2010) Endoluminal scaffolds for vascular reconstruction and exclusion of aneurysms from the cerebral circulation. Stroke 41:S21–S25
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 74:792–799
Zamiri P, Kuang Y, Sharma U et al (2010) The biocompatibility of rapidly degrading polymeric stents in porcine carotid arteries. Biomaterials 31:7847–7855
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 98:224–233
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 136:900–907
Padfield GJ, Newby DE, Mills NL (2010) Understanding the role of endothelial progenitor cells in percutaneous coronary intervention. J Am Coll Cardiol 55:1553–1565
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 88:1269–1276
Acknowledgments
This study was supported by the China Postdoctoral Science Foundation (grant no. 20100481521). We would like to thank MicroPort Medical (Shanghai) Co., Ltd. for the free structures of metal FDs and the delivery systems.
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We declare that we have no conflict of interest.
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Wang, K., Yuan, S., Zhang, X. et al. Biodegradable flow-diverting device for the treatment of intracranial aneurysm: short-term results of a rabbit experiment. Neuroradiology 55, 621–628 (2013). https://doi.org/10.1007/s00234-013-1150-0
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DOI: https://doi.org/10.1007/s00234-013-1150-0