The Derivo Embolization Device, a Second-Generation Flow Diverter for the Treatment of Intracranial Aneurysms, Evaluated in an Elastase-Induced Aneurysm Model
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In recent years, flow diverters have provided a promising alternative to treat complex intracranial aneurysms. In this study, we compare a second-generation flow-diverting device (Derivo Embolization Device) with its prototype flow diverter, in the treatment of elastase-induced aneurysms in New Zealand white rabbits.
The Derivo Embolization Device is a self-expanding stent consisting of 48 nitinol wires. The device was implanted across the necks of 17 elastase-induced aneurysms in New Zealand white rabbits. One additional device was implanted in the abdominal aorta of each animal covering the origin of lumbar arteries. Follow-up was performed after 3 months (n = 8) and 6 months (n = 9) under continuous double antiplatelet therapy. Statuses of angiographic and histological aneurysm occlusion as well as patency of branch arteries and neointimal growth were evaluated and compared with its prototype flow diverter.
The Derivo Embolization Device provided advanced visibility and flexibility, which led to more accurate navigation and placement. Complete aneurysm occlusion rates were noted in 15 cases (88 %), respectively, compared with 5 cases (28 %) with the first-generation device (p = 0.001). Neointimal growth and diameter stenosis were significantly less with the Derivo Embolization Device and declining after 6 months follow-up in the abdominal aorta. Extreme device oversizing led to distal occlusion of the parent vessel in three cases. Covered branch arteries remained patent throughout the entire period of observation.
The Derivo Embolization Device provides excellent occlusion of elastase-induced aneurysms while preserving branch arteries.
KeywordsDigital Subtraction Angiography Abdominal Aorta Subclavian Artery Intracranial Aneurysm Diameter Stenosis
Flow Re-Direction Endoluminal Device
Digital Subtraction Angiography
Internal Carotid Artery
Pipeline Embolization Device
SILK Flow Diverter
This study was supported in part by a research grant of the BMWi (German Ministry of Economic Affairs and Energy, Grant number: KF2335801WL9).
We would like to thank the Head of the Department of Experimental Surgery, Prof. Menger, and his team for supporting this study.
We declare that our 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.
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 20th Symposium Neuroradiologicum Istanbul, Turkey in September 2014.
Conflict of Interest
This study was funded by Acandis GmbH, Pforzheim, Germany. Giorgio Franco Maria Cattaneo and Werner Mailänder, engineers at the company, served as proctors during this study.
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