PT  - JOURNAL ARTICLE
AU  - Cortese, Jonathan
AU  - Forestier, Géraud
AU  - Bardet, Sylvia M
AU  - Perrin, Marie-Laure
AU  - Baudouin, Maxime
AU  - Belgacem, Alexis
AU  - Chauvet, Romain
AU  - Ratsimbazafy, Voahirana
AU  - Sasselina, Gregory
AU  - Chandellier, Daphnée
AU  - Mounier, Jérémy
AU  - Couquet, Claude
AU  - Bosselut, Florence
AU  - Spelle, Laurent
AU  - Mounayer, Charbel
AU  - Terro, Faraj
AU  - Rouchaud, Aymeric
TI  - Preclinical in vitro and in vivo results of the new silk vista flow diverter with P8RI coating
AID  - 10.1136/jnis-2024-021694
DP  - 2024 Jun 24
TA  - Journal of NeuroInterventional Surgery
PG  - jnis-2024-021694
4099  - http://jnis.bmj.com/content/early/2024/06/24/jnis-2024-021694.short
4100  - http://jnis.bmj.com/content/early/2024/06/24/jnis-2024-021694.full
AB  - Background Flow diverting stents (FDS) have transformed the treatment of intracranial aneurysms; however, their metallic structure associated with their intra-luminal positioning hamper angiographic and clinical outcomes. Therefore, there is a need to develop FDS with optimized surfaces that reduce thrombogenicity while promoting the healing process and endothelialization.Methods P8RI, a peptide mimicking the CD31 protein, was previously developed and grafted onto Silk Vista (SV) FDS. P8RI-SV and bare-SV were used in vitro in a blood loop model to test their hemocompatibility using human whole blood and in vivo using the rabbit elastase model for optical coherence tomography (OCT) comparisons of neointimal formation at day 5 and day 28.Results After blood loop incubation, P8RI-SV showed significant reduction in fibrin binding (p=0.004) and platelet adhesion (p=0.041) compared with bare-SV. Similarly, derivative markers measured in blood, thromboxane B2 (platelet activation) and Thrombin-Antithrombin III complexes (coagulation activation), were also significantly reduced in the P8RI-SV group (both p=0.002). In vivo, complete or near-complete occlusion was reached in all aneurysms (n=6) at day 28. Excellent rate of stent-coverage ratio was obtained at day 5 (89.3% (79.1%–98.7%)) comparable to the observation at day 28 (91.8% (79.1%–100%); p=0.44). These rates were significantly higher compared with bare-SV at day 5 (77.8% (58.3%–86.8%); p<0.001) and at day 28 (67.7% (52.6%–88.9%); p<0.0001).Conclusion In vitro results confirm enhanced hemocompatibility with a significant anti-thrombotic effect of the P8RI-SV. In vivo results provide evidence of rapid neo-intimal growth reaching near-complete tissue healing as early as day 5 in a rabbit model.Data may be obtained from a third party and are not publicly available.