Y Ding1, D Dai2, D F Kallmes2, D Schroeder2, C P Kealey3, V Gupta3, A D Johnson3, R Kadirvel2. 1. From the Department of Neurointerventional Radiology (Y.D., D.D., D.F.K., D.S., R.K.), Mayo Clinic, Rochester, Minnesota ding.yonghong@mayo.edu. 2. From the Department of Neurointerventional Radiology (Y.D., D.D., D.F.K., D.S., R.K.), Mayo Clinic, Rochester, Minnesota. 3. NeuroSigma Inc. (C.P.K., V.G., A.D.J.), Los Angeles, California.
Abstract
BACKGROUND AND PURPOSE: Thin film nitinol can be processed to produce a thin microporous sheet with a low percentage of metal coverage (<20%) and high pore attenuation (∼70 pores/mm(2)) for flow diversion. We present in vivo results from the treatment of experimental rabbit aneurysms by using a thin film nitinol-based flow-diversion device. MATERIALS AND METHODS: Nineteen aneurysms in the rabbit elastase aneurysm model were treated with a single thin film nitinol flow diverter. Devices were also placed over 17 lumbar arteries to model perianeurysmal branch arteries of the intracranial circulation. Angiography was performed at 2 weeks (n = 7), 1 month (n = 8), and 3 months (n = 4) immediately before sacrifice. Aneurysm occlusion was graded on a 3-point scale (grade I, complete occlusion; grade II, near-complete occlusion; grade III, incomplete occlusion). Toluidine blue staining was used for histologic evaluation. En face CD31 immunofluorescent staining was performed to quantify neck endothelialization. RESULTS: Markedly reduced intra-aneurysmal flow was observed on angiography immediately after device placement in all aneurysms. Grade I or II occlusion was noted in 4 (57%) aneurysms at 2-week, in 6 (75%) aneurysms at 4-week, and in 3 (75%) aneurysms at 12-week follow-up. All 17 lumbar arteries were patent. CD31 staining showed that 75% ± 16% of the aneurysm neck region was endothelialized. Histopathology demonstrated incorporation of the thin film nitinol flow diverter into the vessel wall and no evidence of excessive neointimal hyperplasia. CONCLUSIONS: In this rabbit model, the thin film nitinol flow diverter achieved high rates of aneurysm occlusion and promoted tissue in-growth and aneurysm neck healing, even early after implantation.
BACKGROUND AND PURPOSE: Thin film nitinol can be processed to produce a thin microporous sheet with a low percentage of metal coverage (<20%) and high pore attenuation (∼70 pores/mm(2)) for flow diversion. We present in vivo results from the treatment of experimental rabbit aneurysms by using a thin film nitinol-based flow-diversion device. MATERIALS AND METHODS: Nineteen aneurysms in the rabbit elastase aneurysm model were treated with a single thin film nitinol flow diverter. Devices were also placed over 17 lumbar arteries to model perianeurysmal branch arteries of the intracranial circulation. Angiography was performed at 2 weeks (n = 7), 1 month (n = 8), and 3 months (n = 4) immediately before sacrifice. Aneurysm occlusion was graded on a 3-point scale (grade I, complete occlusion; grade II, near-complete occlusion; grade III, incomplete occlusion). Toluidine blue staining was used for histologic evaluation. En face CD31 immunofluorescent staining was performed to quantify neck endothelialization. RESULTS: Markedly reduced intra-aneurysmal flow was observed on angiography immediately after device placement in all aneurysms. Grade I or II occlusion was noted in 4 (57%) aneurysms at 2-week, in 6 (75%) aneurysms at 4-week, and in 3 (75%) aneurysms at 12-week follow-up. All 17 lumbar arteries were patent. CD31 staining showed that 75% ± 16% of the aneurysm neck region was endothelialized. Histopathology demonstrated incorporation of the thin film nitinol flow diverter into the vessel wall and no evidence of excessive neointimal hyperplasia. CONCLUSIONS: In this rabbit model, the thin film nitinol flow diverter achieved high rates of aneurysm occlusion and promoted tissue in-growth and aneurysm neck healing, even early after implantation.
Authors: Tobias Struffert; Sabine Ott; Markus Kowarschik; Frederik Bender; Edyta Adamek; Tobias Engelhorn; Philipp Gölitz; Stefan Lang; Charles M Strother; Arnd Doerfler Journal: Eur Radiol Date: 2012-08-16 Impact factor: 5.315
Authors: D F Kallmes; R Hanel; D Lopes; E Boccardi; A Bonafé; S Cekirge; D Fiorella; P Jabbour; E Levy; C McDougall; A Siddiqui; I Szikora; H Woo; F Albuquerque; H Bozorgchami; S R Dashti; J E Delgado Almandoz; M E Kelly; R Turner; B K Woodward; W Brinjikji; G Lanzino; P Lylyk Journal: AJNR Am J Neuroradiol Date: 2014-10-29 Impact factor: 3.825
Authors: Lee A Tan; Kiffon M Keigher; Stephan A Munich; Roham Moftakhar; Demetrius K Lopes Journal: J Neurointerv Surg Date: 2014-02-19 Impact factor: 5.836
Authors: L Cirillo; M Leonardi; M Dall'olio; C Princiotta; A Stafa; L Simonetti; F Toni; R Agati Journal: Interv Neuroradiol Date: 2012-12-03 Impact factor: 1.610
Authors: Andrea M Herrmann; Stephan Meckel; Matthew J Gounis; Leona Kringe; Edith Motschall; Christoph Mülling; Johannes Boltze Journal: J Cereb Blood Flow Metab Date: 2019-02-07 Impact factor: 6.200
Authors: S Gomez-Paz; Y Akamatsu; J M Moore; C S Ogilvy; A J Thomas; C J Griessenauer Journal: AJNR Am J Neuroradiol Date: 2020-02-13 Impact factor: 3.825
Authors: Michael E Coon; Sirkka B Stephan; Vikas Gupta; Colin P Kealey; Matthias T Stephan Journal: Nat Biomed Eng Date: 2019-12-09 Impact factor: 25.671
Authors: Yanxia Lyu; Jie Luo; Yonghong Zhang; ChaoJia Wang; AnRong Li; Yi Zhou; EnFu Du; Hui Wang; JunTao Hu Journal: Biomed Res Int Date: 2020-08-26 Impact factor: 3.411