Background Advances in stent-assisted coiling have incrementally expanded endovascular treatment options for complex cerebral aneurysms. After successful coil consolidation and aneurysm occlusion, endovascular scaffolds are no longer needed. Thus, bioresorbable stents that disappear after aneurysm healing could avoid future risks of in-stent thrombosis and the need for lifelong antiplatelet therapy.
Objective To assess the applicability and compatibility of a bioresorbable magnesium- alloy stent (brMAS) for assisted coiling.
Methods Saccular sidewall aneurysms were created in 84 male Wistar rats and treated with brMAS alone, brMAS + aspirin, or brMAS + coils + aspirin. Control groups included no treatment (natural course), solely aspirin treatment, or conventional cobalt–chromium stent + coils + aspirin treatment. After 1 and 4 weeks, aneurysm specimens were harvested and macroscopically, histologically, and molecularly examined for healing, parent artery perfusion status, and inflammatory reactions. Stent degradation was monitored for up to 6 months with micro-computed and optical coherence tomography.
Results Aneurysms treated with brMAS showed advanced healing, neointima formation, and subsequent stent degradation. Additional administration of aspirin sustained aneurysm healing while reducing stent-induced intraluminal and periadventitial inflammatory responses. No negative interaction was detected between platinum coils and brMAS. Progressive brMAS degradation was confirmed.
Conclusions brMAS induced appropriate healing in this sidewall aneurysm model. The concept of using bioresorbable materials to promote complete aneurysm healing and subsequent stent degradation seems promising. These results should encourage further device refinements and clinical evaluation of this treatment strategy for cerebrovascular aneurysms.
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Contributors BEG and DC conceived the study. BEG, DT, FS, JR, EN, MvG, DG, SLL, HRW, and DC conducted the experiments and acquired data. Analysis and interpretation of data was performed by BEG, DT, DG, LR, JF, SM, and DC. Statistical analysis was performed by BEG, HRW, SM, and DC. BEG took the lead in writing the manuscript with critical feedback from all authors. JF, LR, and SM supervised the project and DC was in charge of the overall direction and planning. All authors approved the final version to be published and agree to be accountable for all aspects of the work.
Funding This work was supported by research funds of the Research Council, Kantonsspital Aarau, Aarau, Switzerland (FR 1400.000.054). The bioresorbable magnesium alloy stents and cobalt-chromium stents were supplied by Biotronik AG, Centre for Vascular Intervention, Bülach, Switzerland. The authors are solely responsible for the design and conduct of the presented study and declare no competing interests.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Not required.