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  • Preliminary In Vivo Evaluation of a Novel Intrasaccular Cerebral Aneurysm Occlusion Device

    Final Number:
    329

    Authors:
    Roham Moftakhar MD; Fangmin Xu; Beverly Aagaard-Kienitz MD; Wendy Crone; Kristyn Masters

    Study Design:
    Laboratory Investigation

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Aneurysm recanalization remains a major challenge in the treatment of intracranial aneurysms with current endovascular technology. Our group has built two versions of a novel aneurysm intrasaccular occlusion device (AIOD) that is intended to address challenges associated with current occlusion devices. The purpose of this study was to perform pilot, proof-of-concept in vivo testing of this new AIOD in swine and canines.

    Methods: Two versions of the AIOD, constructed in either a "coil-in-shell" or "gel-inshell" configuration, were implanted in surgically created sidewall aneurysms in swine for acute occlusion studies, as well as sidewall and bifurcation aneurysms in canines to assess long-term occlusion efficacy. Occlusion at all time points was evaluated by angiography, and neointimal healing at 12 weeks post-implantation in canines was evaluated via histological examination.

    Results: Angiographic analysis showed that both the coil-in-shell and gel-in-shell devices achieved complete aneurysm occlusion immediately following device delivery in sidewall aneurysms in swine. In longer-term canine studies, initial occlusion ranged from 71.3%-100%, which was stable with no recurrence in any of the sidewall aneurysms at the 6 or 12 week time points. Histological analysis demonstrated 0.68 ±0.41mm mature fibromuscular tissue at the neck of the aneurysm, endothelialization of the luminal surface, and no significant inflammatory response.

    Conclusions: Although the processes for sizing and delivering this novel AIOD must be addressed to improve initial occlusion, they exhibit significant promise with respect to minimizing aneurysm recurrence and facilitating thick neointimal coverage at the aneurysm neck.

    Patient Care: Novel intrasaccular flow diverter which could make aneurysm treatment simpler and better long term occlusion of aneurysm

    Learning Objectives: Novel cerebral aneurysm intrasaccular flow diverter made out of novel material which could demonstrate bioactivity

    References:

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