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Evaluation of occurring complications after flow diverter treatment of elastase-induced aneurysm in rabbits using micro-CT and MRI at 9.4 T

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Flow diverters are increasingly being used to treat intracranial aneurysms. This study evaluates occurring complications of flow-diverting devices in the treatment of experimental aneurysms, involving the use of micro-CT and small animal MRI at 9.4 T, in correlation to angiographic and histological findings.

Methods

We previously published two preclinical studies, in which we assessed two different flow diverters in the treatment of elastase-induced aneurysms. Devices have been implanted across the aneurysm neck as well as in the abdominal aorta. From these studies, a total of 65 devices (prototype FD (n = 30) and Derivo embolization device (n = 35)) additionally underwent micro-CT and MRI after angiographic follow-up and before being histologically examined.

Results

The different architectures of both devices were precisely comparable due to high-resolution micro-CT imaging. Micro-CT revealed wire fractures in nine cases (30 %) only with the prototype FD. In three cases (10 %), severe wire fractures correlated with an in-stent stenosis due to intimal hyperplasia. Other complications, like distal stent occlusions and post-stent stenosis, were seen in both groups and verified with both imaging techniques. Osseous metaplasia were correlated to calcifications seen with micro-CT. MRI enabled visualization of the position of the implanted devices relative to the aneurysm and revealed incomplete aneurysm neck coverage with the prototype FD in two cases (6.7 %).

Conclusion

Micro-CT and 9.4-T MRI are valid to discover and understand occurring complications of flow diverters in the preclinical phase and can serve as evaluation tools to minimize complication rates of endovascular devices in the future.

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Abbreviations

FD:

Flow diverter

DSA:

Digital subtraction angiography

AA:

Abdominal aorta

SA:

Subclavian artery

ISS:

In-stent stenosis

PSS:

Post-stent stenosis

sMRI:

Small animal magnet resonance imaging

FLASH:

Fast low angle shot

FISP:

Fast imaging with steady state precession

T:

Tesla

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Acknowledgments

We would like to thank the head of Department of Experimental Surgery, Prof. Menger, and his team for supporting this study. This study was supported in part by a research grant from the BMBF (German Ministry of Education and Research, Grant number: 0314101) and the BMWi (German Ministry of Economic Affairs and Energy, Grant number: KF2335801WL9).

Author information

Authors and Affiliations

  1. Department of Neuroradiology, Saarland University Hospital, Kirrbergerstraße1, 66424, Homburg, Saar, Germany

    Andreas Simgen, Désirée Ley, Ruben Mühl-Benninghaus, Heiko Körner, Wolfgang Reith & Umut Yilmaz

  2. Department of Neuroradiology, Clinic Bremen-Mitte, Bremen, Germany

    Christian Roth

  3. Acandis GmbH, Pforzheim, Germany

    Giorgio Franco Maria Cattaneo

  4. Department of Experimental Surgery, Saarland University Hospital, Homburg, Saar, Germany

    Andreas Müller

  5. Department of Pathology, Saarland University Hospital, Homburg, Saar, Germany

    Yoo-Jin Kim

  6. Department of Cardiology, Saarland University Hospital, Homburg, Saar, Germany

    Bruno Scheller

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  1. Andreas Simgen
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  2. Désirée Ley
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Corresponding author

Correspondence to Andreas Simgen.

Ethics declarations

We declare that all human and animal studies have been approved by the ethics committee of the Saarland University and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

This study was funded by Acandis GmbH, Pforzheim, Germany. GFMC, an engineer at the company, served as proctor during this study.

Additional information

Parts of this study have been published as an oral poster presentation at the meeting of the German Society of Neuroradiology (DGNR) in Cologne, Germany, in October 2013, and as an oral presentation at the XXth Symposium Neuroradiologicum Istanbul, Turkey, in September 2014. Additionally, parts of this study have been published in the Journal of Neuroradiology in 2013, and in Clinical Neuroradiology in 2015.

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Simgen, A., Ley, D., Roth, C. et al. Evaluation of occurring complications after flow diverter treatment of elastase-induced aneurysm in rabbits using micro-CT and MRI at 9.4 T. Neuroradiology 58, 987–996 (2016). https://doi.org/10.1007/s00234-016-1730-x

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