RT Journal Article
SR Electronic
T1 Aspirin treatment prevents inflammation in experimental bifurcation aneurysms in New Zealand White rabbits
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP neurintsurg-2020-017261
DO 10.1136/neurintsurg-2020-017261
A1 Stefan Wanderer
A1 Basil Erwin Grüter
A1 Fabio Strange
A1 Gwendoline Boillat
A1 Sivani Sivanrupan
A1 Jeannine Rey
A1 Michael von Gunten
A1 Luca Remonda
A1 Hans Rudolf Widmer
A1 Daniela Casoni
A1 Lukas Andereggen
A1 Javier Fandino
A1 Serge Marbacher
YR 2021
UL http://jnis.bmj.com/content/early/2021/03/29/neurintsurg-2020-017261.abstract
AB Background Aneurysm wall degeneration is linked to growth and rupture. To address the effect of aspirin (ASA) on aneurysm formation under various wall conditions, this issue was analyzed in a novel rabbit bifurcation model.Methods Bifurcation aneurysms created in 45 New Zealand White rabbits were randomized to vital (n=15), decellularized (n=13), or elastase-degraded (n=17) wall groups; each group was assigned to a study arm with or without ASA. At follow-up 28 days later, aneurysms were evaluated for patency, growth, and wall inflammation at macroscopic and histological levels.Results 36 rabbits survived to follow-up at the end of the trial. None of the aneurysms had ruptured. Patency was visualized in all aneurysms by intraoperative fluorescence angiography and confirmed in 33 (92%) of 36 aneurysms by MRI/MRA. Aneurysm size was significantly increased in the vital (without ASA) and elastase-degraded (with and without ASA) groups. Aneurysm thrombosis was considered complete in three (50%) of six decellularized aneurysms without ASA by MRI/MRA. Locoregional inflammation of the aneurysm complex was significantly reduced in histological analysis among all groups treated with ASA.Conclusion ASA intake prevented inflammation of both the periadventitial tissue and aneurysm wall, irrespective of initial wall condition. Although ASA prevented significant growth in aneurysms with vital walls, this preventive effect did not have an important role in elastase-degraded pouches. In possible translation to the clinical situation, ASA might exert a potential preventive effect during early phases of aneurysm formation in patients with healthy vessels but not in those with highly degenerative aneurysm walls.All data relevant to the study are included in the article or uploaded as supplementary information.