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Evaluation of vessel injury after simulated catheter use in an endothelialized silicone model of the intracranial arteries

  • Interventional Neuroradiology
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Abstract

Purpose

Neurothrombectomy catheters can disrupt or injure the vessel wall. This potential injury is often studied in animal or cadaver models, but prior work suggests that endothelialized silicone models may be an option for early in vitro assessment. The purpose of this work was to create a complex, clinically-relevant endothelialized neurovascular silicone model, and to determine the utility of the model for evaluating vessel injury due to catheter simulated use.

Methods

Models of the ICA and MCA were fabricated out of silicone, sterilized, coated with fibronectin, placed in bioreactors, and endothelialized with HUVECs. These silicone vessels were maintained under flow for 3 and 7 days, and cellular linings were assessed. Subsequently, 24 silicone vessels were created and treated with neurovascular catheters. Vessels were accessed with a guidewire, microcatheter, and/or aspiration catheter, either once (1-pass) or three times (3-pass). Vessels were then fixed, and injury was evaluated through quantitative image analysis and a visual scoring system.

Results

Complex silicone models were successfully endothelialized and maintained with consistent cell linings. The transparent silicone permitted catheter simulated use without fluoroscopy, and injury to the vessel wall was observed and successfully imaged and characterized. Vessels subjected to 3-passes exhibited more injury than 1-pass, and injury increased with the number and size of devices. These results illustrated expected trends and support use of these models for early assessment of vessel injury.

Conclusion

Complex silicone neurovascular models can be endothelialized and used in vitro to assess and compare injury due to the use of neurovascular catheters.

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Acknowledgements

We would like to acknowledge Harrison Oen and Jack Dooley for their assistance with the extensive endothelial cell culture in these studies, and also Jonah Adams and Jake Perisho for their assistance with the confirmatory PECAM-1 staining in the catheter simulated use vessels. We would like to acknowledge Sarena Carniato for her thoughtful review and feedback on the written manuscript.

Funding

This work was funded by Stryker Neurovascular.

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Authors and Affiliations

  1. Biomedical Engineering Department, Cal Poly, 1 Grand Ave, San Luis Obispo, CA, 93407, USA

    Alyssa McCulloch, Brianna Yang & Kristen O’Halloran Cardinal

  2. Stryker Neurovascular Intervention, Research and Development, Fremont, CA, 94538, USA

    Sergey Frenklakh & Pratika Sah

Authors
  1. Alyssa McCulloch
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  2. Brianna Yang
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  3. Sergey Frenklakh
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  4. Pratika Sah
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  5. Kristen O’Halloran Cardinal
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Corresponding author

Correspondence to Kristen O’Halloran Cardinal.

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McCulloch, A., Yang, B., Frenklakh, S. et al. Evaluation of vessel injury after simulated catheter use in an endothelialized silicone model of the intracranial arteries. Neuroradiology 65, 1507–1515 (2023). https://doi.org/10.1007/s00234-023-03197-8

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  • DOI: https://doi.org/10.1007/s00234-023-03197-8

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