(Stroke. 2001;32:492.)
© 2001 American Heart Association, Inc.
Original Contributions |
From the University of Wisconsin Hospital and Clinic, Department of Neuroradiology, Madison (A.S.T., A.H.R., C.M.S.); Boston Scientific Corp/Target Therapeutics, Freemont, Calif (F.V.); and Armed Forces Institute of Pathology, Walter Reed Army Hospital, Washington DC (R.V.).
Correspondence to Charles M. Strother, MD, University of Wisconsin Hospital and Clinic, Department of Neuroradiology, 600 Highland Ave, E1/320, Madison, WI 53792. E-mail strother{at}facstaff.wisc.edu
Background and PurposeMany wide-necked aneurysms are difficult or impossible to treat with the Guglielmi detachable coil (GDC). The purpose of this study was to evaluate the use of a neck bridging device, the TriSpan coil, in combination with standard GDCs for the treatment of wide-necked aneurysms in an experimental canine aneurysm model.
MethodsOf 24 experimental aneurysms in 12 animals, 19 (7 lateral and 12 terminal) were treated with the TriSpan coil in conjunction with standard GDCs. Digital subtraction angiography (DSA) was performed on all animals immediately after treatment. In 6 animals, follow-up DSA and histological evaluation were performed 4 weeks after treatment. In the remaining 6, DSA was done at both 90 and 180 days after treatment. Histological evaluation was done immediately after the 180-day angiographic evaluation.
ResultsThe TriSpan was easy to use in conjunction with the standard GDC. Because of their geometry, some lateral aneurysms were difficult or impossible to treat with this device. Greater than 90% aneurysm occlusion was obtained in all 19 aneurysms. In no instance was there evidence of coil migration, herniation, or aneurysm recanalization. Histological evaluation of the tissue surrounding the TriSpan coil showed tissue responses similar to that seen with standard GDCs.
ConclusionsThese results show that the TriSpan coil in conjunction with standard GDCs can be used safely and effectively for the treatment of wide-necked aneurysms in this canine model. Positioning and deployment of the neck bridge in aneurysms having an acute angle with the long axis of their parent artery are difficult or impossible. It is likely that this device, used in conjunction with the standard GDC, will allow treatment of some wide-necked aneurysms that are not treatable with the GDC alone.
Clinical Neurological Sciences, London Health Sciences Centre University Campus, London, Ontario, Canada
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