RT Journal Article SR Electronic T1 Communicating malapposition of flow diverters assessed with optical coherence tomography correlates with delayed aneurysm occlusion JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 693 OP 697 DO 10.1136/neurintsurg-2017-013502 VO 10 IS 7 A1 King, Robert M A1 Brooks, Olivia W A1 Langan, Erin T A1 Caroff, Jildaz A1 Clarençon, Frédéric A1 Tamura, Takamitsu A1 Wainwright, John Michael A1 Gounis, Matthew J A1 Marosfői, Miklós A1 Puri, Ajit S YR 2018 UL http://jnis.bmj.com/content/10/7/693.abstract AB Background Optical coherence tomography (OCT) is a high resolution intravascular imaging method that allows visualization of flow diverter struts and the vessel wall. In this study, malapposition of the flow diverter that continues into the neck of the aneurysm, named communicating malapposition (CM), was investigated as a potential factor for delayed aneurysm healing.Methods 40 New Zealand White rabbits underwent elastase induced aneurysm creation, and were subsequently assigned to one of four treatment groups based on flow diverter type and administration of antiplatelet therapy. All animals underwent post device deployment balloon angioplasty and subsequent OCT to assess device/vessel apposition. The incidence of CM seen on OCT was assessed with a binary scoring system: 0–CM present; 1–CM absent. At 30 days, DSA was acquired to assess aneurysm healing. Aneurysm healing on terminal DSA was measured using a previously developed 5 point scale, with a score of 3 or 4 considered a positive outcome.Results All animals were grouped into a single cohort for analysis as no difference in the rate of CM or healing was seen in the four treatment groups. Significant interaction between the absence of CM and a positive outcome was confirmed by Fisher exact test (P=0.0034). Angioplasty was shown to treat 33% of the cases of CM seen at implant, and these treated cases overwhelmingly had a positive outcome (P<0.001).Conclusion The use of OCT to assess CM of flow diverters has been shown to be predictive of the 30 day healing rate of an animal model of aneurysms.