Introduction PPODA-QT is a novel liquid embolic under development for the treatment of cerebral aneurysms. The material is prepared and undergoes gelation in a predictable manner over a pre-set length of time for controllable delivery to the aneurysm with balloon protection. We utilized a rabbit-elastase aneurysm model with histological analysis to evaluate tissue response and biocompatibility following PPODA-QT embolization.
Materials and Methods Experimental elastase-induced aneurysms were created via endovascular technique in New Zealand White Rabbits by incubating 100 U of elastase, mixed 1:1 with and 0.5 M calcium chloride, within the carotid stump for 20 minutes with Fogarty balloon protection. Three weeks after elastase treatment, the aneurysms were embolized using balloon remodeling with a Scepter XC (Microvention) across the aneurysm neck and PPODA-QT was delivered behind the balloon with a Velocity microcatheter (Penumbra). Rabbit control and aneurysm tissues were harvested at acute, 1-month, and 3-month timepoints. All tissues were prepared for histology assessment with Van Gieson and H&E staining protocols.
Results The rabbit-elastase aneurysms developed into small aneurysms (<10 mm dome height) with highly variable neck morphologies and beyond-wide dome-to-neck (d:n) ratios. Histological data captured areas of direct device contact with the aneurysm wall and neck, demonstrating elastin reorganization of vessel wall into a smooth muscle layer after 1-month survivals. At the aneurysm neck, a homogenous neointimal (NI) tissue layer (200–300 µm) formed at the PPODA-QT interface, sealing off the parent vessel from the aneurysm dome (figure 1). Results reveal no symptoms of acute inflammation from the elastase incubation and no adverse immune response was evident at 1- and 3-month survival timepoints following PPODA-QT embolization.
Conclusion Following PPODA-QT embolization, NI tissue growth and remodeling was noted with minimal immunological response, indicating that PPODA-QT can be successfully delivered to wider-neck aneurysms and promote aneurysm tissue reorganization and stabilization that facilitates continuous healing at the aneurysm neck. Because experimental aneurysms were uniformly small with inconsistent neck morphology, further testing in larger aneurysm models (i.e. canines) is planned to optimize device delivery and verify healing responses prior to human clinical investigation.
Disclosures T. Becker: 1; C; Brain Aneurysm Foundation Grant-2018. 4; C; Aneuvas Technologies, Inc.. 5; C; Northern Arizona University, Aneuvas Technologies, Inc. A. Huckleberry: 1; C; Brain Aneurysm Foundation Grant-2018. W. Merritt: 1; C; Brain Aneurysm Foundation Grant-2018. 5; C; Northern Arizona University. T. Cotter: 1; C; Brain Aneurysm Foundation Grant-2018. 5; C; McGill University. C. Settanni: 1; C; Brain Aneurysm Foundation Grant-2018. 5; C; Northern Arizona University. A. Ducruet: 1; C; Brain Aneurysm Foundation Grant-2018. 5; C; Barrow Neurological Institute.
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