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Evaluation of a newly designed flow diverter for the treatment of intracranial aneurysms in an elastase-induced aneurysm model, in New Zealand white rabbits

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

In this study, we analyzed angiographic and histologic aneurysm occlusion of a newly designed flow-diverting device. Visibility and flexibility, as well as occlusions of side branches and neointimal proliferation were also evaluated.

Methods

Aneurysms were induced in 18 New Zealand white rabbits and treated with a braided, “closed-loop-designed” device of nitinol. Additional devices were implanted in the abdominal aorta to cover the origin of branch arteries. Angiographic follow-ups were performed immediately after placement of the device, after 3 months (n = 9) and 6 months (n = 9). The status of aneurysm occlusion (using a five-point scale) and the patency of branch arteries were assessed.

Results

Aneurysm occlusion rates were noted as grade 0 in 2 (11 %), grade I in 1 (6 %), grade II in 1 (6 %), grade III in 9 (50 %), and grade IV in 5 (28 %) of 18 aneurysms, respectively, indicating a complete or near-complete occlusion of 78 % under double antiplatelet therapy. Aneurysm occlusion was significantly higher at 6 months follow-up (P = 0.025). Radiopaque markers provided excellent visibility. Limited device flexibility led to incomplete aneurysm neck coverage and grade 0 occlusion rates in two cases. Distal device occlusions were found in three cases, most likely due to an extremely undersized vessel diameter in the subclavian artery. No case of branch artery occlusion was seen. Intimal proliferation and diameter stenosis were moderate.

Conclusion

The tested flow diverter achieved near-complete and complete aneurysm occlusion under double antiplatelet therapy of elastase-induced aneurysms in 78 %, while preserving branch arteries.

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Abbreviations

FD:

Flow diverter

DSA:

Digital subtraction angiography

AA:

Abdominal aorta

SA:

Subclavian artery

ICA:

Internal carotid artery

PED:

Pipeline embolization device

SFD:

SILK flow diverter

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Acknowledgments

We would like to thank Admedes Schuessler GmbH, Pforzheim, Germany, for providing the prototype FDs and delivery systems. We would also like to thank the Head of the Department of Experimental Surgery, Prof. Menger, and his team, for supporting this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany

    Andreas Simgen, Desiree Ley, Umut Yilmaz, Heiko Körner, Ruben Mühl-Benninghaus & Wolfgang Reith

  2. Department of Neuroradiology, Clinic Bremen-Mitte, Bremen, Germany

    Christian Roth

  3. Department of Pathology, Saarland University Hospital, Homburg, Saarland, Germany

    Yoo-Jin Kim

  4. Department of Cardiology, Saarland University Hospital, Homburg, Saarland, Germany

    Bruno Scheller

Authors
  1. Andreas Simgen
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  2. Desiree Ley
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  5. Heiko Körner
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  6. Ruben Mühl-Benninghaus
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  9. Wolfgang Reith
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Correspondence to Andreas Simgen.

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Simgen, A., Ley, D., Roth, C. et al. Evaluation of a newly designed flow diverter for the treatment of intracranial aneurysms in an elastase-induced aneurysm model, in New Zealand white rabbits. Neuroradiology 56, 129–137 (2014). https://doi.org/10.1007/s00234-013-1296-9

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  • DOI: https://doi.org/10.1007/s00234-013-1296-9

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