You are here

  • Home
  • Online First
  • A novel swine model of selective middle meningeal artery catheterization and embolization

Article Text

Article menu
Download PDFPDF
New devices and techniques
Original research
A novel swine model of selective middle meningeal artery catheterization and embolization
  1. Maxim Mokin1,
  2. Donald Pionessa, Jr2,
  3. Carmon Koenigsknecht2,
  4. Liza Gutierrez2,
  5. Swetadri Vasan Setlur Nagesh3,
  6. Karen M Meess Tuttle4,
  7. Mike Spengler4,
  8. Yousef Akkad4,
  9. Kunal Vakharia1,
  10. Maksim Shapiro5,
  11. Matthew J Gounis6,
  12. Elad I Levy7,8,
  13. Adnan H Siddiqui7,8
  1. 1 Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
  2. 2 Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  3. 3 Canon Stroke and Vascular Research Center and Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  4. 4 Jacobs Institute, Buffalo, New York, USA
  5. 5 Radiology, NYU Langone Medical Center, New York, New York, USA
  6. 6 New England Center for Stroke Research, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
  7. 7 Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  8. 8 Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
  1. Correspondence to Dr Adnan H Siddiqui, Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA; asiddiqui{at}ubns.com

Abstract

Background Middle meningeal artery (MMA) embolization is a promising intervention as a stand-alone or adjunct treatment to surgery in patients with chronic subdural hematomas. There are currently no large animal models for selective access and embolization of the MMA for preclinical evaluation of this endovascular modality. Our objective was to introduce a novel in vivo model of selective MMA embolization in swine.

Methods Diagnostic cerebral angiography with selective microcatheter catheterization into the MMA was performed under general anesthesia in five swine. Anatomical variants in arterial meningeal supply were examined. In two animals, subsequent embolization of the MMA with a liquid embolic agent (Onyx-18) was performed, followed by brain tissue harvest and histological analysis.

Results The MMA was consistently localized as a branch of the internal maxillary artery just distal to the origin of the ascending pharyngeal artery. Additional meningeal supply was observed from the external ophthalmic artery, although not present consistently. MMA embolization with Onyx was technically successful and feasible. Histological analysis showed Onyx material within the MMA lumen.

Conclusions Microcatheter access into the MMA in swine with liquid embolic agent delivery represents a reproducible model of MMA embolization. Anatomical variations in the distribution of arterial supply to the meninges exist. This model has a potential application for comparing therapeutic effects of various embolic agents in a preclinical setting that closely resembles the MMA embolization procedure in humans.

  • Subdural
  • Technique
  • Artery
  • Catheter
  • Liquid Embolic Material

Data availability statement

Additional data from this study can be acquired by contacting the corresponding author on reasonable request Not applicable.

https://doi.org/10.1136/jnis-2024-021481

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Additional data from this study can be acquired by contacting the corresponding author on reasonable request Not applicable.

    View Full Text

    Footnotes

    • Contributors Conception and design: LG, CK, KMMT, MM, DP, MS, AHS. Acquisition of data: LG, CK, KMMT, MM, DP, SVSN, AHS. Interpretation of data: all. Drafting the manuscript: CK, MM, MS, AHS. Critically revising the manuscript: all. Reviewed submitted version of manuscript: all. Study supervision: AHS, KMMT, MS, YA. Guarantors: MM, AHS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests MM: Grants: NIH; Consultant: Balt, Cerenovus, Medtronic, Rapid Pulse; Stock options: Bendit Technologies, Borvo Medical, BrainQ, Endostream, Radical Catheter Technologies, Serenity Medical, Synchron, Sim&Cure, QAS.AI, Quantanosis.AI; Payment for expert testimony: Foley Mansfield, Huff Powell Bailey. DP: None. CK: None. LG: Stock options: QAS.AI. SVSN: None. KMMT: None. MS: None. YA: None. KV: Consultant: Imperative Care, MicroVention. MS: None. MJG: Consultant on a fee-per-hour basis for Alembic LLC, Astrocyte Pharmaceuticals, BendIt Technologies, Cerenovus, Imperative Care, Jacob’s Institute, Medtronic Neurovascular, Mivi Neurosciences, phenox GMbH, Q’Apel, Route 92 Medical, Scientia, Simcerre, Stryker Neurovascular, Stryker Sustainability Solutions, Wallaby Medical; holds stock in Imperative Care, InNeuroCo, Galaxy Therapeutics, Kapto, Neurogami and Synchron; Research support from the NIH, the United States – Israel Binational Science Foundation, Anaconda, ApicBio, Arsenal Medical, Axovant, Balt, Cerenovus, Ceretrieve, CereVasc LLC, Cook Medical, Galaxy Therapeutics, Gentuity, Gilbert Foundation, Imperative Care, InNeuroCo, Insera, Jacobs Institute, Magneto, MicroBot, MicroVention, Medtronic Neurovascular, MIVI Neurosciences, Naglreiter MDDO, Neurogami, Q’Apel, Philips Healthcare, Progressive Medical, Pulse Medical, Rapid Medical, Route 92 Medical, Scientia, Stryker Neurovascular, Syntheon, ThrombX Medical, Wallaby Medical, the Wyss Institute and Xtract Medical; Serves as an associate editor for JNIS. EIL: Consulting fees: Clarion, GLG Consulting, Guidepoint Global, Imperative Care, Medtronic, StimMed, Misionix, Mosiac; Payment or honoraria for lectures, presentations, speakers' bureaus, manuscript writing or educational events: Medtronic, Penumbra, MicroVention, Integra; Patents planned, issued or pending: Ultrasonic Surgical Blade; Participation on a Data Safety Monitoring Board or Advisory Board: Stryker (AIS Clinical Advisory Board), NeXtGen Biologics, MEDX, Cognition Medical; Endostream Medical, IRRAS AB; Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: CNS, ABNS, UBNS: Stock or stock options (shareholder or ownership interest): NeXtGen Biologics, RAPID Medical, Claret Medical, Cognition Medical, Imperative Care, Rebound Therapeutics, StimMed, Three Rivers Medical; Other financial or non-financial interests: Haniva Medical Technology (Chief Medical Officer); Medtronic (National PI: Steering Committee for SWIFT Prime and SWIFT Direct trials; Site PI: STRATIS Study Sub 1), MicroVention (Site PI: CONFIDENCE Study). AHS: Financial Interest/Investor/Stock Options/Ownership: Adona Medical, Bend IT Technologies, BlinkTBI, Borvo Medical, Cerebrotech Medical Systems, Code Zero Medical, Cognition Medical, Collavidence, CVAID, E8, Endostream Medical, Galaxy Therapeutics, Hyperion Surgical, Imperative Care, InspireMD, Instylla, Launch NY, Neurolutions, NeuroRadial Technologies (sold to Medtronic in 2021), Neurovascular Diagnostics, Peijia Medical, PerFlow Medical, Piraeus Medical, Q’Apel Medical, QAS.ai, Radical Catheter Technologies, Rebound Therapeutics Corp (purchased 2019 by Integra Lifesciences Corp), Rist Neurovascular (purchased 2020 by Medtronic), Sense Diagnostics, Serenity Medical, Silk Road Medical, Sim & Cure, Spinnaker Medical, StimMed, Synchron, Tulavi Therapeutics, Vastrax, Viseon, Whisper Medical, Willow Medtech, Consultant/Advisory Board: Amnis Therapeutics, Apellis Pharmaceuticals, Boston Scientific, Canon Medical Systems USA, Cardinal Health 200, Cerebrotech Medical Systems, Cerenovus, Cordis, Corindus, Endostream Medical, Hyperfine Operations, Imperative Care, InspireMD, Integra, IRRAS AB, Medtronic, MicroVention, Minnetronix Neuro, Peijia Medical, Penumbra, Piraeus Medical, Q’Apel Medical, Rapid Medical, Serenity Medical, Silk Road Medical, StimMed, Stryker Neurovascular, VasSol, Viz.ai; National PI/Steering Committees: Cerenovus EXCELLENT and ARISE II Trial; Medtronic SWIFT PRIME, VANTAGE, EMBOLISE and SWIFT DIRECT Trials; MicroVention FRED Trial & CONFIDENCE Study; MUSC POSITIVE Trial; Penumbra 3D Separator Trial, COMPASS Trial, INVEST Trial, MIVI Neuroscience EVAQ Trial; Rapid Medical SUCCESS Trial; InspireMD C-GUARDIANS IDE Pivotal Trial; Patent: Patent No. US 11,464,528 B2, Date: October 11, 2022, Clot Retrieval System for Removing Occlusive Clot from a Blood Vessel, Applicant and Assignee: Neuravi Limited (Galway), Role: Co-Inventor.

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