Treatment of carotid siphon aneurysms by use of the Willis stent graft: an angiographic and histopathological study
- 192 Downloads
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.
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.
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.
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.
KeywordsCovered stent Intracranial aneurysm Animal model Carotid siphon
This study is supported by the Doctor Innovation Found of Medical School of Shanghai Jiao Tong University (No. BXJ0933).
- 6.Molyneux AJ, Kerr RC, Yu LM et al (2005) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809–817CrossRefPubMedGoogle Scholar
- 22.Levy EI, Boulos AS, Hanel RA et al (2003) In vivo model of intracranial stent implantation: a pilot study to examine the histological response of cerebral vessels after randomized implantation of heparin-coated and uncoated endoluminal stents in a blinded fashion. J Neurosurg 98:544–553CrossRefPubMedGoogle Scholar
- 23.Jung F, Beysang R, Guceve L et al (1975) Angiography of the cervico-cephalic vessels of the dog. The carotid system. J Chir (Paris) 109:109–118Google Scholar