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Basic science
Original research
Aneurysm healing following treatment with biodegradable embolization materials: assessment in a rat sidewall aneurysm model
  1. Edin Nevzati1,2,3,
  2. Jeannine Rey1,4,
  3. Alexander Spiessberger1,5,
  4. Manuel Moser6,
  5. Michel Roethlisberger3,7,
  6. Basil Erwin Grüter1,8,
  7. Hans Rudolf Widmer1,
  8. Daniel Coluccia1,2,
  9. Serge Marbacher1,4
  1. 1Program for Regenerative Neuroscience, Department for BioMedical Research, University of Bern, Bern, Switzerland
  2. 2Neurosurgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
  3. 3University of Basel, Faculty of Medicine, Basel, Switzerland
  4. 4Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland
  5. 5Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA
  6. 6Neurosurgery, Cantonal Hospital of Graubuenden, Chur, Switzerland
  7. 7Neurosurgery, University Hospital Basel, Basel, Switzerland
  8. 8Division of Neuroradiology, Department of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland
  1. Correspondence to Dr Edin Nevzati, Program for Regenerative Neuroscience, Department for BioMedical Research, University of Bern, Bern, Switzerland; edin.nevzati{at}gmail.com

Abstract

Background Biodegradable materials that dissolve after aneurysm healing are promising techniques in the field of neurointerventional surgery. We investigated the effects of various bioabsorable materials in combination with degradable magnesium alloy stents and evaluated aneurysm healing in a rat aneurysm model.

Methods Saccular aneurysms were created by end-to-side anastomosis in the abdominal aorta of Wistar rats. Untreated arterial grafts were immediately transplanted (vital aneurysms) whereas aneurysms with loss of mural cells were chemically decellularized before implantation. All aneurysms were treated with biodegradable magnesium stents. The animals were assigned to vital aneurysms treated with stent alone or decellularized aneurysms treated with stent alone, detachable coil, or long-term or short-term biodegradable thread. Aneurysm healing, rated microscopically and macroscopically at follow-up days 7 and 21, was defined by both neointima formation and absence of aneurysm volume increase over time.

Results Of 56 animals included, significant increases in aneurysm volume 7 days after surgery were observed in aneurysms with vital and decellularized walls treated with a stent only (P=0.043 each group). Twenty-one days after surgery an increase in aneurysm volume was observed in decellularized aneurysms treated with long- and short-term biodegradable threads (P=0.027 and P=0.028, respectively). Histological changes associated with an increase in aneurysm volume were seen for aneurysm wall inflammation, periadventitial fibrosis, and luminal thrombus.

Conclusions An increase in aneurysm volume was associated with an absence of intrasaccular embolization material (early phase) and the breakdown of intrasaccular biodegradable material over time (late phase). Thrombus remnant and aneurysm wall inflammation promote aneurysm volume increase.

  • Aneurysm
  • Stent
  • Bioactive
  • Inflammation

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jnis-2023-021260

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Twitter @BasilGruter

    • Contributors Conception and design: EN, SM, and DC. Acquisition of data: EN, JR, AS, MM, MR, BEG, HRW, DC, and SM. Analysis and interpretation of data: EN, JR, MM, SM. Drafting the article: EN, JR, and SM. Critical revision of the article: all authors. Statistical analysis: MM and EN. Review of the submitted version of the manuscript: all authors. Approval of the final version of the manuscript on behalf of all authors: EN, JR, BEG, and SM. Study supervision: EN and SM. EN is the study guarantor.

    • Funding The study was supported with a research grant from the research council of the Kantonsspital Aarau (Application number: 1410.000.054).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.