Y-H Ding1, S Ghozy2, D Dai1, W Brinjikji1, D F Kallmes1, R Kadirvel1. 1. From the Department of Radiology, Mayo Clinic, Rochester, Minnesota. 2. From the Department of Radiology, Mayo Clinic, Rochester, Minnesota ghozy.sherief@mayo.edu.
Abstract
BACKGROUND AND PURPOSE: Intracranial aneurysms treated with coils have been associated with incomplete occlusion, particularly in large or wide-neck aneurysms. This study aimed to validate the accuracy of the rabbit elastase model in predicting aneurysm recurrence in humans treated with platinum coils. MATERIALS AND METHODS: Elastase-induced saccular aneurysms were induced in rabbits and embolized with conventional platinum coils. The recurrence rates of aneurysms were retrospectively analyzed. Morphologic characteristics of aneurysms, angiographic outcomes, and histologic healing were evaluated. RESULTS: A total of 28 (15.3%) of 183 aneurysms recurred. The aneurysm recurrence rate observed in this study (15.3%) is similar to those reported in multiple analyses of aneurysm recurrence rates in humans (7%-27%). The rate of recurrence was higher in aneurysms treated without balloon assistance (19/66, 28.8%) compared with those treated with balloon assistance (9/117, 7.7%). Aneurysms treated with balloon-assisted coiling had a lower recurrence rate (OR = 0.17; 95% CI, 0.05-0.47; P = .001) and higher occlusion rate (OR = 6.88; 95% CI, 2.58-20.37; P < .001) compared with those treated without balloon-assisted coiling. In this rabbit elastase-induced aneurysm model, packing density and aneurysm volume were weak predictors of aneurysm recurrence; however, the packing density was a good predictor of the occlusion rate (OR = 1.05; 95% CI, 1.02-1.10; P = .008). CONCLUSIONS: The rabbit elastase aneurysm model may mimic aneurysm recurrence rates observed in humans after platinum coil embolization. Moreover, balloon assistance and high packing densities were significant predictors of aneurysm recurrence and occlusion.
BACKGROUND AND PURPOSE: Intracranial aneurysms treated with coils have been associated with incomplete occlusion, particularly in large or wide-neck aneurysms. This study aimed to validate the accuracy of the rabbit elastase model in predicting aneurysm recurrence in humans treated with platinum coils. MATERIALS AND METHODS: Elastase-induced saccular aneurysms were induced in rabbits and embolized with conventional platinum coils. The recurrence rates of aneurysms were retrospectively analyzed. Morphologic characteristics of aneurysms, angiographic outcomes, and histologic healing were evaluated. RESULTS: A total of 28 (15.3%) of 183 aneurysms recurred. The aneurysm recurrence rate observed in this study (15.3%) is similar to those reported in multiple analyses of aneurysm recurrence rates in humans (7%-27%). The rate of recurrence was higher in aneurysms treated without balloon assistance (19/66, 28.8%) compared with those treated with balloon assistance (9/117, 7.7%). Aneurysms treated with balloon-assisted coiling had a lower recurrence rate (OR = 0.17; 95% CI, 0.05-0.47; P = .001) and higher occlusion rate (OR = 6.88; 95% CI, 2.58-20.37; P < .001) compared with those treated without balloon-assisted coiling. In this rabbit elastase-induced aneurysm model, packing density and aneurysm volume were weak predictors of aneurysm recurrence; however, the packing density was a good predictor of the occlusion rate (OR = 1.05; 95% CI, 1.02-1.10; P = .008). CONCLUSIONS: The rabbit elastase aneurysm model may mimic aneurysm recurrence rates observed in humans after platinum coil embolization. Moreover, balloon assistance and high packing densities were significant predictors of aneurysm recurrence and occlusion.
Authors: Yong Hong Ding; Daying Dai; Debra A Lewis; Mark A Danielson; Ramanathan Kadirvel; Jayawant N Mandrekar; Harry J Cloft; David F Kallmes Journal: AJNR Am J Neuroradiol Date: 2005-10 Impact factor: 3.825
Authors: Scott M Herting; Yonghong Ding; Anthony J Boyle; Daying Dai; Landon D Nash; Solmaz Asnafi; Daniel R Jakaitis; Collin R Johnson; Lance M Graul; Chung Yeh; David F Kallmes; Ramanathan Kadirvel; Duncan J Maitland Journal: J Biomed Mater Res B Appl Biomater Date: 2019-02-18 Impact factor: 3.368
Authors: Juhana Frösen; Anna Piippo; Anders Paetau; Marko Kangasniemi; Mika Niemelä; Juha Hernesniemi; Juha Jääskeläinen Journal: Stroke Date: 2004-08-19 Impact factor: 7.914
Authors: David F Kallmes; Yong Hong Ding; Daying Dai; Ramanathan Kadirvel; Debra A Lewis; Harry J Cloft Journal: Stroke Date: 2007-07-05 Impact factor: 7.914