Rishi Gupta1, Frank D Kolodgie2, Renu Virmani2, Ronen Eckhouse3. 1. Wellstar Medical Group Neurosurgery, Wellstar Neurosciences Network, Marietta, Georgia, USA. 2. Department of Cardiology, CVPath Institute, Gaithersburg, Maryland, USA. 3. Rapid Medical, Yokneam, Israel.
Abstract
BACKGROUND AND PURPOSE: Adjunctive devices are commonly employed in the treatment of wide necked cerebral aneurysms. Balloon remodeling and permanent stent implantation may lead to thromboembolic complications or the need for antiplatelet use. A temporary stent that does not lead to complete flow arrest may be beneficial. METHODS: We studied 20 New Zealand white rabbits in whom aneurysms were created using elastase and ligation of the right common carotid artery. The aneurysms were then embolized with bare platinum coils along with adjunctive treatment using the Comaneci device or the Hyperglide balloon. Assessments were made for endothelial injury using scanning electron microscopy (SEM) and light microscopy. RESULTS: 20 rabbits of mean±SD weight 3.1±0.2 kg were studied. Twelve rabbits were treated with the Comaneci device and eight with the Hyperglide balloon. There were no substantial differences on SEM or light microscopy in the subacute and chronic phase to suggest the Comaneci device caused endothelial injury. CONCLUSIONS: The Comaneci device is a new adjuvant treatment for bridging of wide necked aneurysms with the advantage of averting flow arrest during deployment. There does not appear to be any evidence of significant endothelial damage during deployment in preclinical studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND AND PURPOSE: Adjunctive devices are commonly employed in the treatment of wide necked cerebral aneurysms. Balloon remodeling and permanent stent implantation may lead to thromboembolic complications or the need for antiplatelet use. A temporary stent that does not lead to complete flow arrest may be beneficial. METHODS: We studied 20 New Zealand white rabbits in whom aneurysms were created using elastase and ligation of the right common carotid artery. The aneurysms were then embolized with bare platinum coils along with adjunctive treatment using the Comaneci device or the Hyperglide balloon. Assessments were made for endothelial injury using scanning electron microscopy (SEM) and light microscopy. RESULTS: 20 rabbits of mean±SD weight 3.1±0.2 kg were studied. Twelve rabbits were treated with the Comaneci device and eight with the Hyperglide balloon. There were no substantial differences on SEM or light microscopy in the subacute and chronic phase to suggest the Comaneci device caused endothelial injury. CONCLUSIONS: The Comaneci device is a new adjuvant treatment for bridging of wide necked aneurysms with the advantage of averting flow arrest during deployment. There does not appear to be any evidence of significant endothelial damage during deployment in preclinical studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: M Asif Taqi; Eytan Raz; Anastasia Vechera; Maksim Shapiro; Rishi Gupta; Joseph Haynes; Philipp Taussky; Ramesh Grandhi; Howard A Riina; Peter Kim Nelson; Erez Nossek Journal: Cerebrovasc Dis Date: 2021-05-10 Impact factor: 2.762