Published online before print February 12, 2004, doi: 10.1161/01.STR.0000117577.94345.CC
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2004;35:786.)
© 2004 American Heart Association, Inc.
Progress Reviews |
Gene Therapy and Endovascular Treatment of Intracranial Aneurysms
From the Department of Radiology (J.R.) and Centre de recherche (E.R.), Centre hospitalier de l’Université de Montréal–Hôpital Notre-Dame, Montreal, Quebec, Canada.
Reprint requests to Jean Raymond, MD, Interventional Neuroradiology Research Laboratory, Centre hospitalier de l’Université de Montréal–Hôpital Notre-Dame, 1560 Sherbrooke St E, Room M-8203, Montreal, Quebec H2L 4M1, Canada. E-mail dr_jean_raymond{at}hotmail.com
Background— Endovascular treatment of intracranial aneurysms is safe and effective but too often is followed by recurrences. Gene therapy may improve healing after embolization, and endovascular approaches may offer future in situ delivery systems designed to prevent aneurysm rupture.
Summary of Review— Advances in coil technology have focused on coating strategies designed to modify the biological reaction to the embolic agent. Gene therapy in cardiovascular applications is limited by low efficiency and transient gene expression. Current advances include the potential use of circulating progenitor cells for ex vivo genetic manipulations followed by in vivo delivery. Direct gene transfer may also be enhanced in situ by coils carrying antibody-tethered adenovirus or through the use of cell-specific or radiation-inducible promoters. Candidate genes that may be of value in promoting healing after endovascular treatment include growth factors and metalloproteinase inhibitors. A better understanding of the biology of aneurysm is necessary to conceive strategies designed to control the development of these lesions before their rupture.
Conclusions— Many technical difficulties remain to be solved, but the combination of gene therapy and endovascular techniques offers multiple therapeutic possibilities in the future control of intracranial aneurysms.
Key Words: aneurysm, intracranial • endovascular therapy • gene therapy
This article has been cited by other articles:
 |
|
 |
|
  R. Kadirvel, D. Dai, Y.H. Ding, M.A. Danielson, D.A. Lewis, H.J. Cloft, and D.F. Kallmes Endovascular Treatment of Aneurysms: Healing Mechanisms in a Swine Model Are Associated with Increased Expression of Matrix Metalloproteinases, Vascular Cell Adhesion Molecule-1, and Vascular Endothelial Growth Factor, and Decreased Expression of Tissue Inhibitors of Matrix Metalloproteinases AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 849 - 856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.I. Mangrum, F. Farassati, R. Kadirvel, C.P. Kolbert, S. Raghavakaimal, D. Dai, Y.H. Ding, D. Grill, V.G. Khurana, and D.F. Kallmes mRNA Expression in Rabbit Experimental Aneurysms: A Study Using Gene Chip Microarrays AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 864 - 869. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Dai, Y. H. Ding, M. A. Danielson, R. Kadirvel, L. W. Hunter, W.-Z. Zhan, G. A. Helm, D. A. Lewis, H. J. Cloft, G. C. Sieck, et al. Endovascular Treatment of Experimental Aneurysms by Use of Fibroblast-Coated Platinum Coils: An Angiographic and Histopathologic Study Stroke, January 1, 2007; 38(1): 170 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Raymond, C. Mounayer, I. Salazkin, A. Metcalfe, G. Gevry, C. Janicki, S. Roorda, and P. Leblanc Safety and Effectiveness of Radioactive Coil Embolization of Aneurysms: Effects of Radiation on Recanalization, Clot Organization, Neointima Formation, and Surrounding Nerves in Experimental Models Stroke, August 1, 2006; 37(8): 2147 - 2152. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Watanabe and D. D. Heistad Targeting cerebral arteries for gene therapy Exp Physiol, May 1, 2005; 90(3): 327 - 331. [Abstract] [Full Text] [PDF]
|
|