A New Endoluminal, Flow-Disrupting Device for Treatment of Saccular Aneurysms

Stroke - Tập 38 Số 8 - Trang 2346-2352 - 2007
David F. Kallmes1, Yong Hong Ding2, Daying Dai2, Ramanathan Kadirvel2, Debra A. Lewis2, Harry J. Cloft2
1Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
2From the Department of Radiology, Mayo Clinic, Rochester, MN.

Tóm tắt

Background and Purpose— We report a preclinical study of a new endoluminal device for aneurysm occlusion to test the hypothesis that the device, even without use of intrasaccular coil placement, could occlude saccular aneurysms without causing substantial parent artery compromise or compromise of adjacent, small branch arteries. Methods— The Pipeline Neuroendovascular Device (Pipeline NED; Chestnut Medical Technologies, Inc) is a braided, tubular, bimetallic endoluminal implant aimed at occlusion of saccular aneurysms through flow disruption along the aneurysm neck. The device was implanted across the necks of 17 elastase-induced aneurysms in the New Zealand white rabbit model and followed for 1 month (n=6), 3 months (n=5), and 6 months (n=6). In each subject, a second device was implanted in the abdominal aorta to cover the origins of lumbar arteries. Aneurysm occlusion rates by angiography (grade 1, complete occlusion; grade 2, near-complete occlusion; and grade 3, incomplete occlusion) were documented. Percent area stenosis of the parent arteries was calculated. Presence of distal emboli in the downstream vessels in the parent artery and branch artery stenosis or occlusion was noted. Results— Grades 1, 2, and 3 occlusion rates were noted in 9 (53%), 6 (35%), and 2 (12%) of 17 aneurysms, respectively, indicating an 88% rate of complete or near complete occlusion. No cases of branch artery occlusion or distal emboli in the downstream vessels of the parent artery, specifically the subclavian artery, were seen. Parent artery compromise from neointimal hyperplasia was minimal in most cases. Conclusions— The Pipeline NED is a trackable, bio- and hemocompatible device able to occlude saccular aneurysms with preservation of the parent artery and small, adjacent branch vessels.

Từ khóa


Tài liệu tham khảo

Saatci I, Cekirge HS, Ozturk MH, Arat A, Ergungor F, Sekerci Z, Senveli E, Er U, Turkoglu S, Ozcan OE, Ozgen T. Treatment of internal carotid artery aneurysms with a covered stent: experience in 24 patients with mid-term follow-up results. AJNR Am J Neuroradiol. 2004; 25: 1742–1749.

10.1227/01.NEU.0000159645.86823.AF

10.3171/jns.2005.102.2.0235

10.2214/ajr.174.2.1740349

Fujiwara NH, Cloft HJ, Marx WF, Short JG, Jensen ME, Kallmes DF. Serial angiography in an elastase-induced aneurysm model in rabbits: evidence for progressive aneurysm enlargement after creation. AJNR Am J Neuroradiol. 2001; 22: 698–703.

10.1016/0735-1097(92)90476-4

Ding YH, Dai D, Lewis DA, Cloft HJ, Kallmes DF. Angiographic and histologic analysis of experimental aneurysms embolized with platinum coils, Matrix, and Hydrocoil. AJNR Am J Neuroradiol. 2005; 26: 1757–1763.

10.1227/01.NEU.0000223650.11954.6C

Masuo O, Terada T, Walker G, Tsuura M, Matsumoto H, Tohya K, Kimura M, Nakai K, Itakura T. Study of the patency of small arterial branches after stent placement with an experimental in vivo model. AJNR Am J Neuroradiol. 2002; 23: 706–710.

10.1016/S1522-1865(99)00023-2

10.3174/ajnr.A0507

Killer M, Richling B, Minnich B, Lametschwandtner A, Plenk H. Unexpected tissue engineering: cartilage neoformation in long-term Hydrocoil ®- occluded experimental aneurysms. European Cells and Materials. 2004; 7 (suppl 1): 43.

10.1210/er.2003-0015

Ding YH, Dai D, Lewis DA, Danielson MA, Kadirvel R, Cloft HJ, Kallmes DF. Long-term patency of elastase-induced aneurysm model in rabbits. AJNR Am J Neuroradiol. 2006; 27: 139–141.

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Stroke

Tập 38 Số 8

2346-2352

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